Cut VTE With These Tips

The prevention of venous thromboembolism in hospitals remains a high patient-safety priority, and there are several concrete policy and practice steps that can help, according VTE expert William H. Geerts.

A coordinated nationwide strategy using a single set of guidelines and standardized resources – policies, local guidelines, order sets, measurement tools – is needed, he said during a webinar sponsored by the Partnership for Patients and the National Priorities Partnership.

There should also be consequences for adhering to VTE prophylaxis guidelines, such as accreditation, transfer payments, or public reporting, Dr. Geerts said.

For the local level, he delineated eight key strategies to successfully implementing quality DVT prophylaxis:

• Adequate local commitment and resources.

• Organization-wide standardized simple policy.

• Minimization of variation in practice.

• Inclusion of VTE prophylaxis in order sets with an opt-out approach.

• Responsibility for VTE falls on everyone hospital wide.

• Implementation of mandatory audits and feedback.

• Measurement of success of interventions in reducing VTE.

• Implementation of consequences of adherence.

Dr. Geerts, who is professor of medicine at the University of Toronto and director of the thromboembolism program at Sunnybrook Health Sciences Centre, also in Toronto, pointed out that 60% of all VTEs are hospital acquired, making VTE a major public health priority. It’s estimated that 187,000 hospital-acquired VTEs occur each year in the United States. "Most of these are preventable," he said.

The Partnership for Patients aims to halve preventable VTEs by 2013. The rationale for including thromboprophylaxis as a key national patient safety goal involves four points, according to Dr. Geerts. VTE is common in hospital patients. The acute and long-term outcomes for patients with VTE are bad. VTE is preventable and can be accomplished safely and inexpensively. Preventing VTE is the standard of care for almost all hospital patients.

Importantly, more than 400 randomized studies prove that VTE can be prevented safely and inexpensively, he said. Data also suggest that "it’s not just enough to give prophylaxis but the quality of the prophylaxis is also very important. We can expect that if we provide quality prophylaxis for there to be – not only fewer [DVTs] – but also [lower] costs associated with doing that." He included a list of generally accepted thromboprophylaxis options.

He pointed out that patients who are fully mobile and are expected to have a hospital stay of less than 2 days don’t need thromboprophylaxis. However, this is a very small proportion of hospital patients.

Resources: Society of Hospital Medicine’s Venous Thromboembolism Resource Room and the National Quality Forum Patient Safety Page.

Dr. Geerts’ conflicts of interest were not provided by webinar sponsors. He has previously disclosed consulting or receiving speaking fees from Bayer Healthcare, Boehringer-Ingelheim, Covidien, Pfizer,and Sanofi Aventis.

The prevention of venous thromboembolism in hospitals remains a high patient-safety priority, and there are several concrete policy and practice steps that can help, according VTE expert William H. Geerts.

A coordinated nationwide strategy using a single set of guidelines and standardized resources – policies, local guidelines, order sets, measurement tools – is needed, he said during a webinar sponsored by the Partnership for Patients and the National Priorities Partnership.

There should also be consequences for adhering to VTE prophylaxis guidelines, such as accreditation, transfer payments, or public reporting, Dr. Geerts said.

For the local level, he delineated eight key strategies to successfully implementing quality DVT prophylaxis:

• Adequate local commitment and resources.

• Organization-wide standardized simple policy.

• Minimization of variation in practice.

• Inclusion of VTE prophylaxis in order sets with an opt-out approach.

• Responsibility for VTE falls on everyone hospital wide.

• Implementation of mandatory audits and feedback.

• Measurement of success of interventions in reducing VTE.

• Implementation of consequences of adherence.

Dr. Geerts, who is professor of medicine at the University of Toronto and director of the thromboembolism program at Sunnybrook Health Sciences Centre, also in Toronto, pointed out that 60% of all VTEs are hospital acquired, making VTE a major public health priority. It’s estimated that 187,000 hospital-acquired VTEs occur each year in the United States. "Most of these are preventable," he said.

The Partnership for Patients aims to halve preventable VTEs by 2013. The rationale for including thromboprophylaxis as a key national patient safety goal involves four points, according to Dr. Geerts. VTE is common in hospital patients. The acute and long-term outcomes for patients with VTE are bad. VTE is preventable and can be accomplished safely and inexpensively. Preventing VTE is the standard of care for almost all hospital patients.

Importantly, more than 400 randomized studies prove that VTE can be prevented safely and inexpensively, he said. Data also suggest that "it’s not just enough to give prophylaxis but the quality of the prophylaxis is also very important. We can expect that if we provide quality prophylaxis for there to be – not only fewer [DVTs] – but also [lower] costs associated with doing that." He included a list of generally accepted thromboprophylaxis options.

He pointed out that patients who are fully mobile and are expected to have a hospital stay of less than 2 days don’t need thromboprophylaxis. However, this is a very small proportion of hospital patients.

Resources: Society of Hospital Medicine’s Venous Thromboembolism Resource Room and the National Quality Forum Patient Safety Page.

Dr. Geerts’ conflicts of interest were not provided by webinar sponsors. He has previously disclosed consulting or receiving speaking fees from Bayer Healthcare, Boehringer-Ingelheim, Covidien, Pfizer,and Sanofi Aventis.

The prevention of venous thromboembolism in hospitals remains a high patient-safety priority, and there are several concrete policy and practice steps that can help, according VTE expert William H. Geerts.

A coordinated nationwide strategy using a single set of guidelines and standardized resources – policies, local guidelines, order sets, measurement tools – is needed, he said during a webinar sponsored by the Partnership for Patients and the National Priorities Partnership.

There should also be consequences for adhering to VTE prophylaxis guidelines, such as accreditation, transfer payments, or public reporting, Dr. Geerts said.

For the local level, he delineated eight key strategies to successfully implementing quality DVT prophylaxis:

• Adequate local commitment and resources.

• Organization-wide standardized simple policy.

• Minimization of variation in practice.

• Inclusion of VTE prophylaxis in order sets with an opt-out approach.

• Responsibility for VTE falls on everyone hospital wide.

• Implementation of mandatory audits and feedback.

• Measurement of success of interventions in reducing VTE.

• Implementation of consequences of adherence.

Dr. Geerts, who is professor of medicine at the University of Toronto and director of the thromboembolism program at Sunnybrook Health Sciences Centre, also in Toronto, pointed out that 60% of all VTEs are hospital acquired, making VTE a major public health priority. It’s estimated that 187,000 hospital-acquired VTEs occur each year in the United States. "Most of these are preventable," he said.

The Partnership for Patients aims to halve preventable VTEs by 2013. The rationale for including thromboprophylaxis as a key national patient safety goal involves four points, according to Dr. Geerts. VTE is common in hospital patients. The acute and long-term outcomes for patients with VTE are bad. VTE is preventable and can be accomplished safely and inexpensively. Preventing VTE is the standard of care for almost all hospital patients.

Importantly, more than 400 randomized studies prove that VTE can be prevented safely and inexpensively, he said. Data also suggest that "it’s not just enough to give prophylaxis but the quality of the prophylaxis is also very important. We can expect that if we provide quality prophylaxis for there to be – not only fewer [DVTs] – but also [lower] costs associated with doing that." He included a list of generally accepted thromboprophylaxis options.

He pointed out that patients who are fully mobile and are expected to have a hospital stay of less than 2 days don’t need thromboprophylaxis. However, this is a very small proportion of hospital patients.

Resources: Society of Hospital Medicine’s Venous Thromboembolism Resource Room and the National Quality Forum Patient Safety Page.

Dr. Geerts’ conflicts of interest were not provided by webinar sponsors. He has previously disclosed consulting or receiving speaking fees from Bayer Healthcare, Boehringer-Ingelheim, Covidien, Pfizer,and Sanofi Aventis.