Assess the compliance with ACCP-based VTE prophylaxis hospital wide guidelines, identify opportunities for improvement, and modify the system to imporve compliance with guidelines.
The study was conducted in an 800-bed tertiary care medical center. The primary outcome is improvment in Compliance with VTE prophylaxis guidelines. Concurrent review of all inpatient for the presence of risk factors and compliance with guidelines was started in 2006 before introducing any change in the system. Such process measurement was made one of the quality indicators that is routinely measured and reported. Changes in the system were made the last quarter of 2006 based on learning from the practice in the ICU as the compliance was above100% as well as based on research showing the effectiveness of multidisciplinary. A multidisciplinary team consisting of nursing, physicians and ITA experts are responsible for the changes. The team continued to meet regularly to assess performance and make system changes as needed. Intervention: Multidisciplinary System based changes to facilitate performance improvement in the form of nursing screening for risk factors, electronic reminders for physicians, preprinted admission order form, user-friendly tools to summarize guidelines (unit specific posters), developing a hospital policy for VTE prophylaxis, awareness event, and provider specific feedback on performance.
Despite the adaptation of the ACCP guidelines by the hospital, compliance with VTE prophylaxis guidelines at base line was 68% (100% in the ICU). The practice in the ICU was different from non ICU areas because of having pre printed order sheet that address VTE prophylaxis and serve as a reminder. After implementing the changes, hospital wide compliance with prophylaxis improved to above 90% in 2007 and 2008.
Multidisciplinary approach improves VTE prophylaxis and results in better protection of patients against VTE.
All hospitals need to adopt a multidisciplinary approach to the prevention of VTE.
Mohammed Hijazi, No Financial Disclosure Information; No Product/Research Disclosure Information