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Journal of Thrombosis and Thrombolysis

, Volume 25, Issue 2, pp 146–150 | Cite as

Electronic alerts for hospitalized high-VTE risk patients not receiving prophylaxis: a cohort study

  • Steven Baroletti
  • Kristin Munz
  • Jonathan Sonis
  • John Fanikos
  • Karen Fiumara
  • Marilyn Paterno
  • Samuel Z. Goldhaber
Article

Abstract

Background Despite existing consensus guidelines, venous thromboembolism (VTE) prophylaxis is underused in high-risk hospitalized patients. The present study evaluated the effects of an electronic alert to the responsible physician in a cohort of hospitalized high-risk patients not receiving VTE prophylaxis. Methods The absence of VTE prophylaxis orders in hospitalized patients at high-risk for VTE triggered an electronic alert to the responsible physician. We studied a cohort of 866 patients whose physicians were alerted that their patients were at high-risk but receiving no VTE prophylaxis. The electronic alert recommended that the responsible physician order preventive measures. We followed each patient for 90 days to determine whether imaging-confirmed symptomatic VTE occurred. Results 9,527 patients were identified as high-risk for VTE. 9% (866) were not receiving prophylaxis, compared with 18% in the intervention arm of a previous randomized trial (P < 0.001). In our current cohort study, 82% (713) of patients were Medical Service patients. Physician response to alerts resulted in prophylactic measures for 37.7% of those alerted. Symptomatic VTE at 90 days occurred in 5.1% of patients in the present cohort group. Conclusion Implementation of a computer alert program increased prophylaxis rates. However, the majority of alerted physicians in the cohort study did not order VTE prophylaxis despite the alerts. Therefore, novel strategies must be employed to further improve the use of VTE prophylaxis in hospitalized high-risk patients, especially in Medical Service patients.

Keywords

Venous thromboembolism Prophylaxis Electronic alerts DVT 

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Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Steven Baroletti
    • 1
  • Kristin Munz
    • 1
  • Jonathan Sonis
    • 1
  • John Fanikos
    • 1
  • Karen Fiumara
    • 1
  • Marilyn Paterno
    • 1
  • Samuel Z. Goldhaber
    • 1
  1. 1.PharmacyBrigham and Women’s HospitalBostonUSA

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