We appreciate the recent success of Elliott et al1 and Kershaw et al2 in improving heparin dosing. Based on drug use evaluation in two of our local teaching hospitals, we have also noted the need for improved heparin dosing based on current literature. For example, most of the patients in our hospitals still receive heparin 1000 U/h (vs 1300 U/h or weight-based dosing). We report an effort to educate house staff regarding heparin dosing guidelines from the American College of Chest Physicians Consensus Conference on Antithrombotic Therapy.3 Our primary goals were to improve prescribing patterns for initial maintenance heparin doses, rebolus doses in response to subtherapeutic activated partial thromboplastin time, and subsequent adjustment of maintenance doses. To achieve these goals, we evaluated a time-efficient method of sharing current guidelines with house staff.
At the first of each month from October 1993 to April 1994, the medicine