Audit‐guided action can improve the compliance with thromboembolic prophylaxis prescribing to hospitalized, acutely ill older adults

Timmons, Suzanne; O’Callaghan, Claire; O’Connor, Marie; O’Mahony, Denis; Twomey, C.

doi:10.1111/j.1538-7836.2005.01472.x

Cited by 9 publications

(5 citation statements)

References 7 publications

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“…Educational programs alone [32, 37, 38] are not generally sufficient to bring about reliable VTE prophylaxis, but are needed to foster appropriate use of order sets and protocols. Periodic audit and feedback and computerized decision support can also be very effective [31, 39–43], particularly when there is an institutional protocol to hold up as the defining standard for adequate prophylaxis, but some of the more sophisticated tools are beyond the reach of many improvement teams.…”

Section: The Essential Intervention: a Vte Prevention Protocolmentioning

confidence: 99%

Designing and implementing effective venous thromboembolism prevention protocols: lessons from collaborative efforts

Maynard

Stein

2009

J Thromb Thrombolysis

100

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Hospital acquired venous thromboembolism (VTE) is a major source of morbidity and mortality, yet proven prevention measures are often underutilized. The lack of a validated VTE risk assessment model, difficulty integrating VTE risk assessment and prevention protocols into the routine process of care, and the lack of standardized metrics for VTE prophylaxis have all been barriers. Recently, a VTE risk assessment/prevention protocol has been validated, leading to portable strategies achieving breakthrough levels of adequate prophylaxis in a variety of inpatient settings. VTE prevention protocol design and implementation strategies have been collected in implementation guides available from the Society of Hospital Medicine and the Agency for Healthcare Research and Quality. These guides were the centerpieces of national collaborative efforts to improve VTE involving over 150 medical centers, honing the approach to accelerate improvement described in this article. Embedding a VTE prevention protocol into admission, transfer, and perioperative order sets is a key strategy. A VTE prevention protocol is defined as a VTE risk assessment with no more than three levels of risk, tightly linked to recommended prophylaxis for each level. A balance between the need to provide protocol guidance and the need for efficiency and ease-of-use by the clinician must be maintained. The power of this protocol driven approach is bolstered by a quality improvement framework, multidisciplinary teams, ongoing monitoring of the process, and real time identification and mitigation of non-adherents via a technique that measures progress and prompts concurrent intervention, an approach we call “measure-vention.”

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Section: The Essential Intervention: a Vte Prevention Protocolmentioning

confidence: 99%

Designing and implementing effective venous thromboembolism prevention protocols: lessons from collaborative efforts

Maynard

Stein

2009

J Thromb Thrombolysis

100

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“…More success has been described using multicomponent strategies encompassing modalities such as audit, pre-printed orders, and computerised reminders, which have the potential to significantly increase the number of at-risk patients receiving protective treatment [7,14,15].…”

Section: Discussionmentioning

confidence: 99%

Improving venous thromboembolic disease prophylaxis in medical inpatients: a role for education and audit

et al. 2010

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“…El establecimiento de protocolos, registros de actividad y su seguimiento han demostrado mejorar la indicación en términos cuantitativos y cualitativos. Por ejemplo, en el trabajo de Kucher et al 41 , el uso de alertas asociadas a la fi cha electrónica de cada paciente permitió aumentar el uso de profi laxis tanto farmacológica (23,6 vs 13%) como mecánica (10 vs 1,5%). Esto se asoció a una reducción signifi cativa de 41% de presentar algún evento tromboembóli-co a 3 meses (4,9 vs 8,2%).…”

Section: Estrategias Para Mejorar La Indicación De Profi Laxis En El unclassified

“…Esto se asoció a una reducción signifi cativa de 41% de presentar algún evento tromboembóli-co a 3 meses (4,9 vs 8,2%). De hecho, la guía del ACCP 1 recomienda el diseño de una estrategia activa en cada hospital, establecida como política formal para toda la institución 40,41 . En nuestro servicio de medicina interna hemos implementado un protocolo de profi laxis de enfermedad tromboembólica buscando optimizar el uso correcto de la profi laxis farmacológica y mecánica en nuestros pacientes (Figura 1).…”

Section: Estrategias Para Mejorar La Indicación De Profi Laxis En El unclassified

Profilaxis de enfermedad tromboembólica en pacientes hospitalizados con patología médica, estrechando la brecha entre las guías y la práctica clínica

2011

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Audit‐guided action can improve the compliance with thromboembolic prophylaxis prescribing to hospitalized, acutely ill older adults

Cited by 9 publications

References 7 publications

Designing and implementing effective venous thromboembolism prevention protocols: lessons from collaborative efforts

Designing and implementing effective venous thromboembolism prevention protocols: lessons from collaborative efforts

Improving venous thromboembolic disease prophylaxis in medical inpatients: a role for education and audit

Profilaxis de enfermedad tromboembólica en pacientes hospitalizados con patología médica, estrechando la brecha entre las guías y la práctica clínica

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