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Anticoagulation Clinic aims to keep patients safe, make testing easier

  • Category: News
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  • Written By: María Rodríguez Ornelas

VISALIA – Anticoagulant medications can save lives by preventing blood clots, but they are also one of the medications most likely to land someone in the Emergency Department.

Getting patients on the right dosage takes close monitoring. Too little and the cardiac or clotting disorder patient risks developing a clot; too much and they might bleed more than usual. Weight or dietary changes and drug interactions can affect the dosage as well.

The high risk of these medications is why the Visalia Medical Clinic opened its Anticoagulation Clinic three years ago at the 5400 W. Hillsdale site. Headed by Andrea Van Beek, a nurse practitioner who holds a doctorate degree in nursing, the clinic helps patients navigate the required blood tests needed while taking anticoagulants.

In the last three years, the clinic has cared for 470 patients who take various medications for thinning their blood, including Coumadin (Warfarin), Eliquis (Apixaban), Xarelto (Rivaroxaban), Pradaxa (Dabigatran), and Lovenox (Enoxaparin). Many of Van Beek’s patients take the medication Coumadin (Warfarin) which requires the most frequent blood tests out of all the anticoagulants.

Before Van Beek came to Visalia Medical Clinic, patients were working with their primary care physician or cardiologist to manage their dosage levels. Realizing the opportunity to centralize care for patients taking blood thinners, Van Beek started the anticoagulation clinic where she implemented protocols based on the current research and guidelines. “All I focus on is anticoagulant medications. By centering in on just this aspect of a patient’s care, I can ensure they receive education and close attention to keep them from bleeding or clotting.”

Since her work is in preventing adverse incidents, Van Beek noted that she can’t really know how many events she is helping prevent. “Did we help avoid an emergency department visit? It is hard to tell, but we know the research that has been done states that patients who receive care in an anticoagulation clinic have less ED and hospital visits for bleeding and clotting than patients who receive anticoagulation care in other settings.” She notes that rates for her patients making emergency department visits are low.

Clinic patients, especially those taking Coumadin (Warfarin) usually come in on a regular basis, whether weekly or up to every other month for blood testing. When the COVID-19 pandemic struck in March, many patients didn’t feel comfortable coming into the clinic, as they didn’t want to risk an exposure. “I knew we had to find a way to test patient’s blood in a manner which was safe, and would make them feel comfortable, so we quickly adapted, and started doing drive up fingerstick testing. We also found it was more convenient for patients with mobility issues to be seen without having to get out of their car” Van Beek said.

The clinic has four reserved parking spaces so when patients arrive, Van Beek comes out to see them in their car. “I check their blood, give them the results and dosing instructions, perform a basic assessment, and answer any questions,” she explained.

To make the regular tests a convenient as possible, the clinic offers multiple testing options, including the lab, fingerstick testing inside the building and out in the parking lot, along with the option of a home test machine for those unable to travel. “We work with the patient to make it convenient for them,” Van Beek said.

In addition to providing regular monitoring and testing for patients, the clinic also assists with stopping any of the various anticoagulant medications for surgeries or procedures. Additionally, Van Beek works with patients to be sure they can afford their blood thinning agents.

“It is an honor to serve patients, and to keep them safe and healthy,” Van Beek says – “I’m a native of Tulare County…it is a privilege to care for my community.”

Visalia Medical Clinic offers the expertise of providers who offer a wide variety of specialties, along with telehealth visits, a lab, imaging, physical therapy and more. For information, call 738-7500 or visit