Preventing hospital‐acquired venous thromboembolism: Improving patient safety with interdisciplinary teamwork, quality improvement analytics, and data transparency
BACKGROUND Hospital‐acquired venous thromboembolism (HA‐VTE) is a potentially preventable cause of morbidity and mortality. Despite high rates of venous thromboembolism (VTE) prophylaxis in accordance with an institutional guideline, VTE remains the most common hospital‐acquired condition in our ins...
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Published in | Journal of hospital medicine Vol. 11; no. S2; pp. S38 - S43 |
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Main Authors | , , , , , , , , |
Format | Journal Article |
Language | English |
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United States
Frontline Medical Communications
01.12.2016
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Abstract | BACKGROUND
Hospital‐acquired venous thromboembolism (HA‐VTE) is a potentially preventable cause of morbidity and mortality. Despite high rates of venous thromboembolism (VTE) prophylaxis in accordance with an institutional guideline, VTE remains the most common hospital‐acquired condition in our institution.
OBJECTIVE
To improve the safety of all hospitalized patients, examine current VTE prevention practices, identify opportunities for improvement, and decrease rates of HA‐VTE.
DESIGN
Pre/post assessment.
SETTING/PATIENTS
Urban academic tertiary referral center, level 1 trauma center, safety net hospital; all patients.
INTERVENTION
We formed a multidisciplinary VTE task force to review all HA‐VTE events, assess prevention practices relative to evidence‐based institutional guidelines, and identify improvement opportunities. The task force developed an electronic tool to facilitate efficient VTE event review and designed decision‐support and reporting tools, now integrated into the electronic health record, to bring optimal VTE prevention practices to the point of care. Performance is shared transparently across the institution.
MEASUREMENTS
Harborview benchmarks process and outcome performance, including patient safety indicators and core measures, against hospitals nationally using Hospital Compare and Vizient data.
RESULTS
Our program has resulted in >90% guideline‐adherent VTE prevention and zero preventable HA‐VTEs. Initiatives have resulted in a 15% decrease in HA‐VTE and a 21% reduction in postoperative VTE.
CONCLUSIONS
Keys to success include the multidisciplinary approach, clinical roles of task force members, senior leadership support, and use of quality improvement analytics for retrospective review, prospective reporting, and performance transparency. Ongoing task force collaboration with frontline providers is critical to sustained improvements. Journal of Hospital Medicine 2016;11:S38–S43. © 2016 Society of Hospital Medicine |
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AbstractList | BACKGROUND
Hospital‐acquired venous thromboembolism (HA‐VTE) is a potentially preventable cause of morbidity and mortality. Despite high rates of venous thromboembolism (VTE) prophylaxis in accordance with an institutional guideline, VTE remains the most common hospital‐acquired condition in our institution.
OBJECTIVE
To improve the safety of all hospitalized patients, examine current VTE prevention practices, identify opportunities for improvement, and decrease rates of HA‐VTE.
DESIGN
Pre/post assessment.
SETTING/PATIENTS
Urban academic tertiary referral center, level 1 trauma center, safety net hospital; all patients.
INTERVENTION
We formed a multidisciplinary VTE task force to review all HA‐VTE events, assess prevention practices relative to evidence‐based institutional guidelines, and identify improvement opportunities. The task force developed an electronic tool to facilitate efficient VTE event review and designed decision‐support and reporting tools, now integrated into the electronic health record, to bring optimal VTE prevention practices to the point of care. Performance is shared transparently across the institution.
MEASUREMENTS
Harborview benchmarks process and outcome performance, including patient safety indicators and core measures, against hospitals nationally using Hospital Compare and Vizient data.
RESULTS
Our program has resulted in >90% guideline‐adherent VTE prevention and zero preventable HA‐VTEs. Initiatives have resulted in a 15% decrease in HA‐VTE and a 21% reduction in postoperative VTE.
CONCLUSIONS
Keys to success include the multidisciplinary approach, clinical roles of task force members, senior leadership support, and use of quality improvement analytics for retrospective review, prospective reporting, and performance transparency. Ongoing task force collaboration with frontline providers is critical to sustained improvements. Journal of Hospital Medicine 2016;11:S38–S43. © 2016 Society of Hospital Medicine BACKGROUND Hospital-acquired venous thromboembolism (HA-VTE) is a potentially preventable cause of morbidity and mortality. Despite high rates of venous thromboembolism (VTE) prophylaxis in accordance with an institutional guideline, VTE remains the most common hospital-acquired condition in our institution. OBJECTIVE To improve the safety of all hospitalized patients, examine current VTE prevention practices, identify opportunities for improvement, and decrease rates of HA-VTE. DESIGN Pre/post assessment. SETTING/PATIENTS Urban academic tertiary referral center, level 1 trauma center, safety net hospital; all patients. INTERVENTION We formed a multidisciplinary VTE task force to review all HA-VTE events, assess prevention practices relative to evidence-based institutional guidelines, and identify improvement opportunities. The task force developed an electronic tool to facilitate efficient VTE event review and designed decision-support and reporting tools, now integrated into the electronic health record, to bring optimal VTE prevention practices to the point of care. Performance is shared transparently across the institution. MEASUREMENTS Harborview benchmarks process and outcome performance, including patient safety indicators and core measures, against hospitals nationally using Hospital Compare and Vizient data. RESULTS Our program has resulted in >90% guideline-adherent VTE prevention and zero preventable HA-VTEs. Initiatives have resulted in a 15% decrease in HA-VTE and a 21% reduction in postoperative VTE. CONCLUSIONS Keys to success include the multidisciplinary approach, clinical roles of task force members, senior leadership support, and use of quality improvement analytics for retrospective review, prospective reporting, and performance transparency. Ongoing task force collaboration with frontline providers is critical to sustained improvements. Journal of Hospital Medicine 2016;11:S38-S43. © 2016 Society of Hospital Medicine BACKGROUNDHospital-acquired venous thromboembolism (HA-VTE) is a potentially preventable cause of morbidity and mortality. Despite high rates of venous thromboembolism (VTE) prophylaxis in accordance with an institutional guideline, VTE remains the most common hospital-acquired condition in our institution.OBJECTIVETo improve the safety of all hospitalized patients, examine current VTE prevention practices, identify opportunities for improvement, and decrease rates of HA-VTE.DESIGNPre/post assessment.SETTING/PATIENTSUrban academic tertiary referral center, level 1 trauma center, safety net hospital; all patients.INTERVENTIONWe formed a multidisciplinary VTE task force to review all HA-VTE events, assess prevention practices relative to evidence-based institutional guidelines, and identify improvement opportunities. The task force developed an electronic tool to facilitate efficient VTE event review and designed decision-support and reporting tools, now integrated into the electronic health record, to bring optimal VTE prevention practices to the point of care. Performance is shared transparently across the institution.MEASUREMENTSHarborview benchmarks process and outcome performance, including patient safety indicators and core measures, against hospitals nationally using Hospital Compare and Vizient data.RESULTSOur program has resulted in >90% guideline-adherent VTE prevention and zero preventable HA-VTEs. Initiatives have resulted in a 15% decrease in HA-VTE and a 21% reduction in postoperative VTE.CONCLUSIONSKeys to success include the multidisciplinary approach, clinical roles of task force members, senior leadership support, and use of quality improvement analytics for retrospective review, prospective reporting, and performance transparency. Ongoing task force collaboration with frontline providers is critical to sustained improvements. Journal of Hospital Medicine 2016;11:S38-S43. © 2016 Society of Hospital Medicine. BACKGROUND Hospital‐acquired venous thromboembolism (HA‐VTE) is a potentially preventable cause of morbidity and mortality. Despite high rates of venous thromboembolism (VTE) prophylaxis in accordance with an institutional guideline, VTE remains the most common hospital‐acquired condition in our institution. OBJECTIVE To improve the safety of all hospitalized patients, examine current VTE prevention practices, identify opportunities for improvement, and decrease rates of HA‐VTE. DESIGN Pre/post assessment. SETTING/PATIENTS Urban academic tertiary referral center, level 1 trauma center, safety net hospital; all patients. INTERVENTION We formed a multidisciplinary VTE task force to review all HA‐VTE events, assess prevention practices relative to evidence‐based institutional guidelines, and identify improvement opportunities. The task force developed an electronic tool to facilitate efficient VTE event review and designed decision‐support and reporting tools, now integrated into the electronic health record, to bring optimal VTE prevention practices to the point of care. Performance is shared transparently across the institution. MEASUREMENTS Harborview benchmarks process and outcome performance, including patient safety indicators and core measures, against hospitals nationally using Hospital Compare and Vizient data. RESULTS Our program has resulted in >90% guideline‐adherent VTE prevention and zero preventable HA‐VTEs. Initiatives have resulted in a 15% decrease in HA‐VTE and a 21% reduction in postoperative VTE. CONCLUSIONS Keys to success include the multidisciplinary approach, clinical roles of task force members, senior leadership support, and use of quality improvement analytics for retrospective review, prospective reporting, and performance transparency. Ongoing task force collaboration with frontline providers is critical to sustained improvements. Journal of Hospital Medicine 2016;11:S38–S43. © 2016 Society of Hospital Medicine Hospital-acquired venous thromboembolism (HA-VTE) is a potentially preventable cause of morbidity and mortality. Despite high rates of venous thromboembolism (VTE) prophylaxis in accordance with an institutional guideline, VTE remains the most common hospital-acquired condition in our institution. To improve the safety of all hospitalized patients, examine current VTE prevention practices, identify opportunities for improvement, and decrease rates of HA-VTE. Pre/post assessment. Urban academic tertiary referral center, level 1 trauma center, safety net hospital; all patients. We formed a multidisciplinary VTE task force to review all HA-VTE events, assess prevention practices relative to evidence-based institutional guidelines, and identify improvement opportunities. The task force developed an electronic tool to facilitate efficient VTE event review and designed decision-support and reporting tools, now integrated into the electronic health record, to bring optimal VTE prevention practices to the point of care. Performance is shared transparently across the institution. Harborview benchmarks process and outcome performance, including patient safety indicators and core measures, against hospitals nationally using Hospital Compare and Vizient data. Our program has resulted in >90% guideline-adherent VTE prevention and zero preventable HA-VTEs. Initiatives have resulted in a 15% decrease in HA-VTE and a 21% reduction in postoperative VTE. Keys to success include the multidisciplinary approach, clinical roles of task force members, senior leadership support, and use of quality improvement analytics for retrospective review, prospective reporting, and performance transparency. Ongoing task force collaboration with frontline providers is critical to sustained improvements. Journal of Hospital Medicine 2016;11:S38-S43. © 2016 Society of Hospital Medicine. |
Author | Schleyer, Anneliese M. Beingessner, Daphne M. Dumitru, Roxana Robinson, Ellen Pergamit, Ronald Hayes, Kimberly Taylor, Mark Zaros, Mark C. Cuschieri, Joseph |
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References | 2014; 9 2012; 141 2010; 38 2016 2010; 26 e_1_2_7_6_1 e_1_2_7_5_1 e_1_2_7_4_1 e_1_2_7_3_1 e_1_2_7_8_1 e_1_2_7_7_1 e_1_2_7_14_1 e_1_2_7_13_1 GH Guyatt (e_1_2_7_2_1) 2012; 141 e_1_2_7_12_1 e_1_2_7_11_1 e_1_2_7_10_1 Maynard G (e_1_2_7_9_1) 2016 |
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Snippet | BACKGROUND
Hospital‐acquired venous thromboembolism (HA‐VTE) is a potentially preventable cause of morbidity and mortality. Despite high rates of venous... Hospital-acquired venous thromboembolism (HA-VTE) is a potentially preventable cause of morbidity and mortality. Despite high rates of venous thromboembolism... BACKGROUND Hospital-acquired venous thromboembolism (HA-VTE) is a potentially preventable cause of morbidity and mortality. Despite high rates of venous... BACKGROUNDHospital-acquired venous thromboembolism (HA-VTE) is a potentially preventable cause of morbidity and mortality. Despite high rates of venous... |
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SubjectTerms | Benchmarking Decision Support Systems, Clinical - utilization Guideline Adherence Humans Patient Care Team Patient Safety - statistics & numerical data Quality Improvement Venous Thromboembolism - prevention & control |
Title | Preventing hospital‐acquired venous thromboembolism: Improving patient safety with interdisciplinary teamwork, quality improvement analytics, and data transparency |
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