Journal of Thrombosis and Thrombolysis

, Volume 32, Issue 3, pp 293–302

Performance measures for improving the prevention of venous thromboembolism: achievement in clinical practice

Article

DOI: 10.1007/s11239-011-0605-6

Cite this article as:
Wilson, K.C. & Merli, G.J. J Thromb Thrombolysis (2011) 32: 293. doi:10.1007/s11239-011-0605-6

Abstract

Venous thromboembolism (VTE) is a common complication during and after hospitalization for acute medical illness or surgery. Despite the existence of evidence-based guidelines for VTE prevention, real-world prescribing practices are frequently suboptimal. Specific performance measures relating to VTE prevention and treatment have been developed by US health care organizations to increase adherence with best-practice recommendations and ultimately reduce the number of preventable VTE events. Two measures developed by the Surgical Care Improvement Project have been endorsed by the National Quality Forum (NQF) and focus on VTE prevention. In addition, six measures have been developed recently by The Joint Commission in collaboration with the NQF; three measures relate to VTE prevention and three focus on treatment. To attain widespread achievement of these performance goals, it is essential to raise awareness of their existence and specifications. It is also imperative that hospitals develop and implement effective VTE protocols. The use of multiple, active strategies, such as computer decision support systems with regular audit and feedback, may be particularly valuable approaches to improve current practices within an integrated quality improvement program. During practical implementation of VTE protocols at Norton Healthcare (Kentucky’s largest healthcare system), strong leadership, physician engagement, and caregiver accountability were identified as key factors influencing the process. As such, more hospitals may be able to increase adherence with guidelines, improve achievement of quality goals, and help to reduce the substantial burden associated with avoidable VTE.

Keywords

Venous thromboembolism Deep-vein thrombosis Pulmonary embolism Prophylaxis Guideline adherence Anticoagulation 

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  1. 1.Clinical Effectiveness & Quality Norton HealthcareLouisvilleUSA
  2. 2.Department of Medicine and Surgery, Jefferson Center for Vascular DiseasesThomas Jefferson University HospitalPhiladelphiaUSA