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Background Hospital‐acquired venous thromboembolism (VTE) is a major cause of morbidity and mortality. Aims To determine the proportion of patients with hospital‐acquired VTE that are preventable. Methods This was a retrospective study of patients in two tertiary care hospitals in Sydney, Australia. Data were collected for patients with hospital‐acquired VTE based on International Statistical Classification of Diseases and Related Health Problems, 10th Revision, Australian Modification (ICD‐10‐AM) coding from January 2018 to May 2020. Patients were classified as low, moderate or high risk of developing a VTE during hospitalisation based on demographic and clinical factors. A hospital‐acquired VTE was considered to be potentially preventable if there was suboptimal prophylaxis in the absence of contraindications. Suboptimal therapy included at least one of the following related to VTE prophylaxis: low dose, missed dose (prior to developing a VTE), suboptimal drug and delayed start (>24 h from admission). Results There were 229 patients identified with VTE based on ICD‐10‐AM coding. A subset of 135 patients were determined to have actual hospital‐acquired VTE. Of these, there were no patients at low risk, 64% (87/135) at moderate risk and 44% (48/135) at high risk of developing a VTE. Most (65%; n = 88/135) patients had one or more contraindications to receive recommended prophylaxis. Overall, the proportion of patients who received suboptimal prophylaxis was 11% (15/135). Conclusion Approximately one out of 10 hospital‐acquired VTE are preventable. Hospitals should focus on measuring and reporting VTE that are preventable to provide a more accurate measure of the burden of VTE that can be reduced by improving care.

Background Facility-level review of hospital-acquired venous thromboembolism (HA-VTE) cases, including pulmonary embolism (PE) and deep vein thrombosis (DVT), can provide insight into the local drivers of this preventable complication. Aim To determine the nature of HA-VTE, patient characteristics, VTE risk assessment completion and appropriateness of prescribed VTE prophylaxis at a metropolitan tertiary referral hospital and to compare the number of HA-VTE detected by audit of imaging scans with those reported by clinical coding. Methods We conducted a retrospective electronic medical record audit encompassing all patients diagnosed with HA-VTE via ventilation-perfusion scan, computed tomographic pulmonary angiography and/or doppler ultrasound using a demographic and VTE risk assessment audit tool during selected months of 2017-2019. We compared the number of manually audited cases with the number of performance unit-coded cases for the same months. Results The months of May 2017, October 2017, April to July 2018 and April to July 2019 were included. There was a significant difference between HA-VTE detected via manual audit (147 events) and hospital coding (18 events), p=0.002. Manual audit patients were majority non-surgical (65%), female (58%), over 60 years (80%), at moderate VTE risk (71%) with reduced mobility (52%). There were 108 DVT-only (73%), 23 PE-only (16%) and 16 DVT plus PE events (11%). Notable risk factors were moderate to major surgery (30%), active malignancy or cancer treatment (24%) and active infection (27%). Most patients were prescribed appropriate VTE prophylaxis (74%) and had documented VTE risk assessment (68%). Appropriate VTE prophylaxis was significantly associated with using an electronic clinical decision support tool during VTE risk assessment (p=0.024). Conclusion Facility-driven HA-VTE audits provide opportunity to developed targeted initiatives for at-risk patients at a local level. Greater numbers of HA-VTE identified via manual audit suggest the need for future real-time documentation of HA-VTE to assist with efficient case review. Disclosures No relevant conflicts of interest to declare.