Abstract
Venous thromboembolism (VTE) remains a significant public health problem in the United States, particularly for hospitalized patients. Approximately two-thirds of all VTE events are associated with recent hospitalization. Despite the well-known risks of VTE, multiple studies have demonstrated underuse of VTE prophylaxis and clinicians often do not provide evidence-based care for those patients with confirmed VTE. In January 2005, the National Quality Forum initiated a project to develop national consensus standards on organization policies, preferred practices, and performance measures for the prevention and treatment of VTE. In addition to the organizational policy statement and 17 preferred practices, eight national performance measures addressing various aspects of VTE prevention and care have been endorsed. There is now a broad consensus on standardized measures of quality for the prevention and treatment of VTE, and a national commitment to collect and publicly report data on the quality of care for this important health problem.
Similar content being viewed by others
References
Silverstein MD, Heit JA, Mohr DN, Petterson TM, O’Fallon WM, Melton LJ III (1998) Trends in the incidence of deep vein thrombosis and pulmonary embolism: a 25-year population-based study. Arch Intern Med 158:585–593
Anderson FA Jr, Wheeler HB, Goldberg RJ, Hosmer DW, Patwardhan NA, Jovanovic B, Forcier A, Dalen JE (1991) A population-based perspective of the hospital incidence and case-fatality rates of deep vein thrombosis and pulmonary embolism. The Worcester DVT Study. Arch Intern Med 151:933–938
Heit J (2008) The epidemiology of venous thromboembolism in the community. Arterioscler Thromb Vasc Biol 28:370–372
Office of the Surgeon General. The surgeon general’s call to action to prevent deep vein thrombosis and pulmonary embolism—2008. Available at: http://www.surgeongeneral.gov/topics/deepvein/. Accessed 29 July 2009
Heit JA, Melton LJ III, Lohse CM, Petterson TM, Silverstein MD, Mohr DN, O’Fallon WM (2001) Incidence of venous thromboembolism in hospitalized patients vs community residents. Mayo Clin Proc 76:1102–1110
Heit JA, O’Fallon WM, Petterson TM, Lohse CM, Silverstein MD, Mohr DN, Melton LJ III (2002) Relative impact of risk factors for deep vein thrombosis and pulmonary embolism: a population-based study. Arch Intern Med 162:1245–1248
Agency for Healthcare Research and Quality. Preventing hospital-acquired venous thromboembolism: a guide for effective quality improvement. Available at: http://www.ahrq.gov/QUAL/vtguide/. Accessed 29 July 2009
Cohen AT, Agnelli G, Anderson FA, Arcelus JI, Bergqvist D, Brecht JG, Greer IA, Heit JA, Hutchinson JL, Kakkar AK, Mottier D, Oger E, Samama MM, Spannagl M, VTE Inpact Assessment Group in Europe (VITAE) (2007) Venous thromboembolism (VTE) in Europe. The number of VTE events and associated morbidity and mortality. Thromb Haemost 98:756–764
Shojania KJ, Duncan BW, McDonald KM, Wachter RM, Markowitz AJ (2001) Making health care safer: a critical analysis of patient safety practices. Evid Rep Technol Assess (Summ) 43:1–668
National Quality Forum (2009) Safe practices for better healthcare—2009 update: a consensus report. NQF, Washington, DC
White RH, Gettner S, Newman JM, Trauner KB, Romano PS (2000) Predictors of re-hospitalization for symptomatic venous thromboembolism after total hip arthroplasty. N Engl J Med 343:1758–1764
Bergqvist D, Agnelli G, Cohen AT, Eldor A, Nilsson PE, Le Moigne-Amrani A, Dietrich-Neto F, ENOXACAN II Investigators (2002) Duration of prophylaxis against venous thromboembolism with enoxaparin after surgery for cancer. N Engl J Med 346:975–980
National Quality Forum (NQF) (2006) National voluntary consensus standards for prevention and care of venous thromboembolism—policy, preferred practices, and initial performance measures: a consensus report. NQF, Washington, DC
National Quality Forum (NQF) (2008) National voluntary consensus standards for prevention and care of venous thromboembolism: additional performance measures: a consensus report. NQF, Washington, DC
ACCP-NHLBI National Conference on Antithrombotic Therapy. Chest 1986; 89:1S–106S
American College of Chest Physicians (2008) Antithrombotic and thrombolytic therapy: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest 133:71S–968S
Anderson FA Jr, Wheeler HB, Goldberg RJ, Hosmer DW, Forcier A, Patwardhan NA (1991) Physician practices in the prevention of venous thromboembolism. Ann Intern Med 115:591–595
Bratzler DW, Raskob GE, Murray CK, Bumpus LJ, Piatt DS (1998) Underuse of venous thromboembolism prophylaxis for general surgery patients: physician practices in the community hospital setting. Arch Intern Med 158:1909–1912
Stratton MA, Anderson FA, Bussey HI, Caprini JA, Comerota A, Haines ST, Hawkins DW, O’Connell MB, Smith RC, Stringer KA (2000) Prevention of venous thromboembolism: adherence to the 1995 American College of Chest Physicians Consensus Guidelines for surgical patients. Arch Intern Med 160:334–340
Rahim SA, Panju A, Pai M, Ginsberg J (2003) Venous thromboembolism prophylaxis in medical inpatients: a retrospective chart review. Thromb Res 111:215–219
Goldhaber SZ, Tapson VF (2004) A prospective registry of 5,451 patients with ultrasound-confirmed deep vein thrombosis. Am J Cardiol 93:259–262
Tapson VF, Hyers TM, Waldo AL, Ballard DJ, Becker RC, Caprini JA, Khetan R, Wittkowsky AK, Colgan KJ, Shillington AC, NABOR (National Anticoagulation Benchmark and Outcomes Report) Steering Committee (2005) Antithrombotic therapy practices in US hospitals in an era of practice guidelines. Arch Intern Med 165:1458–1464
Caprini JA, Tapson VF, Hyers TM, Waldo AL, Wittkowsky AK, Friedman R, Colgan KJ, Shillington AC, NABOR Steering Committee (2005) Treatment of venous thromboembolism: adherence to guidelines and impact of physician knowledge, attitudes, and beliefs. J Vasc Surg 42:726–733
American Public Health Association (2003) White paper. deep-vein thrombosis: advancing awareness to protect patient lives. Available at: http://www.apha.org/NR/rdonlyres/A209F84A-7C0E-4761-9ECF-61D22E1E11F7/0/DVT_White_Paper.pdf. Accessed 29 July 2009
Prandoni P, Lensing AW, Cogo A, Cuppini S, Villalta S, Carta M, Cattelan AM, Polistena P, Bernardi E, Prins MH (1996) The long-term clinical course of acute deep venous thrombosis. Ann Intern Med 125:1–7
Kyrle PA, Minar E, Bialonczyk C, Hirschl M, Weltermann A, Eichinger S (2004) The risk of recurrent venous thromboembolism in men and women. N Engl J Med 350:2558–2563
Mohr DN, Silverstein MD, Heit JA, Petterson TM, O’Fallon WM, Melton LJ (2000) The venous stasis syndrome after deep venous thrombosis or pulmonary embolism: a population-based study. Mayo Clin Proc 75:1249–1256
Kahn SR, Kearon C, Julian JA, Mackinnon B, Kovacs MJ, Wells P, Crowther MA, Anderson DR, Van Nguyen P, Demers C, Solymoss S, Kassis J, Geerts W, Rodger M, Hambleton J, Ginsberg JS, Extended Low-intensity Anticoagulation for Thrombo-embolism (ELATE) Investigators (2005) Predictors of the post-thrombotic syndrome during long-term treatment of proximal deep vein thrombosis. J Thromb Haemost 3:718–723
Prandoni P, Kahn SR (2009) Post-thrombotic syndrome: prevalence, prognostication and need for progress. Br J Haematol 145:286–295
Williams SC, Schmaltz SP, Morton DJ, Koss RG, Loeb JM (2005) Quality of care in US hospitals as reflected by standardized measures, 2002–2004. N Engl J Med 353:255–264
Bratzler DW (2006) The Surgical Infection Prevention and Surgical Care Improvement Projects: promises and pitfalls. Am Surg 72:1010–1016
Lindenauer PK, Remus D, Roman S, Rothberg MB, Benjamin EM, Ma A, Bratzler DW (2007) Public reporting and pay for performance in hospital quality improvement. N Engl J Med 356:486–496
Bratzler DW, Nsa W, Houck PM (2007) Performance measures for pneumonia: are they valuable, and are process measures adequate? Curr Opin Infect Dis 20:182–189
Bratzler DW, Hunt DR (2006) The Surgical Infection Prevention and Surgical Care Improvement Projects: national initiatives to improve outcomes for patients having surgery. Clin Infect Dis 43:322–330
Centers for Medicare & Medicaid Services. Specifications manual for national hospital quality measures. Available at: http://www.qualitynet.org/. Accessed 28 July 2009
Centers for Medicare & Medicaid Services. Medicare program; changes to the hospital inpatient prospective payment systems for acute care hospitals and fiscal year 2010 rates; and changes to the long-term care hospital prospective payment system and rate years 2010 and 2009 rates. Available at: http://www.federalregister.gov/OFRUpload/OFRData/2009-18663_PI.pdf. Accessed 10 August 2009
Kakkar AK, Davidson BL, Haas SK, Investigators Against Thromboembolism (INATE) Core Group (2004) Compliance with recommended prophylaxis for venous thromboembolism: improving the use and rate of clinical uptake of clinical practice guidelines. J Thromb Haemost 2:221–227
Kucher N, Koo S, Quiroz R, Cooper JM, Paterno MD, Soukonnikov B, Goldhaber SZ (2005) Electronic alerts to prevent venous thromboembolism among hospitalized patients. N Engl J Med 352:969–977
Caprini JA, Hyers TM (2006). Compliance with antithrombotic guidelines. Manag Care 15:53–60, 66
Nutescu EA (2007) Assessing, preventing, and treating venous thromboembolism: evidence-based approaches. Am J Health Syst Pharm 64(11 Suppl 7):S5–13
Society of Hospital Medicine. Venous Thromboembolism Resource Room. Available at: http://www.hospitalmedicine.org/ResourceRoomRedesign/RR_VTE/VTE_Home.cfm. Accessed 30 July 2009
Acknowledgements
The analyses upon which this publication is based were performed under Contract Number HHSM-500-2008-OK9thC funded by the Centers for Medicare & Medicaid Services, an agency of the U.S. Department of Health and Human Services.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Bratzler, D.W. Development of national performance measures on the prevention and treatment of venous thromboembolism. J Thromb Thrombolysis 29, 148–154 (2010). https://doi.org/10.1007/s11239-009-0407-2
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11239-009-0407-2