“Leaning” the Process of Venous Thromboembolism Prophylaxis

Biffl, Walter L.; Beno, Matthew; Goodman, Philip L.; Bahia, Amit; Sabel, Allison; Snow, Karen; Steele, Andrew; Swartwood, Claire; Thienelt, C. D.; MacKenzie, Thomas D.; Mehler, Philip S.

doi:10.1016/s1553-7250(11)37012-2

Cited by 17 publications

(8 citation statements)

References 17 publications

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“…Another high-risk condition in hospitalized patients, and the leading cause of potentially preventable death, is represented by venous thromboembolism (VTE). By designing and implementing an evidence-based risk-assessment tool and clinical practice guideline, embedded into admission order sets in the computerized physician order system (CPOE), the compliance with the VTE prophylaxis guideline was drastically increased [8]. Denver Health's performance in preventing venous thromboembolism climbed to the top 10 percent nationwide [8].…”

Section: Introductionmentioning

confidence: 99%

A structured approach to improving patient safety: Lessons from a public safety-net system

2011

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Section: Introductionmentioning

confidence: 99%

A structured approach to improving patient safety: Lessons from a public safety-net system

2011

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“…Studies have shown that up to one-half of postoperative or hospital-associated DVT or PE events are preventable if hospitals closely adhere to standardised protocols of risk assessment and prevention and implement continuous quality improvement activities (26)(27)(28)(29)(30). Not only can appropriate prophylaxis reduce the risk of life-threatening blood clots, it can also potentially save hospitals and payers money (31)(32)(33).…”

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confidence: 99%

Incidence-based cost estimates require population-based incidence data. A critique of Mahan et al.

Grosse¹

2012

Thromb Haemost

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As a health economist, I read with interest the article by Mahan et al. which calculates the monetary burden of deep-vein thrombosis (DVT) in the absence of pulmonary embolism (PE) (1). Mahan et al. multiply numbers of incident and recurrent DVT cases by average costs per incident or recurrent case. That approach requires estimates of incidence and recurrence derived from population-based epidemiologic data using a case definition consistent with that used to calculate per-person medical cost estimates. In particular, because the percase cost estimates are specific to symptomatic DVT cases, symptomatic DVT incidence must be used to assess aggregate costs. The "weakest link" in cost studies is most commonly found in epidemiologic measures such as incidence, case fatality, and preventable fraction rather than economic methods or cost data (2). Population-based US studies report an annual incidence of clinically recognised venous thromboembolism (VTE; which includes both DVT and PE) between 1.0 and 1.5 per 1,000 adults (3-5). Since most population-based studies report that DVT accounts for approximately 65-70% of VTE (4-8), the annual incidence of symptomatic DVT should be between 0.65 and 1.0 per 1,000 US adults, or a total of 160,000 to 240,000 new cases of symptomatic DVT per year. Extrapolating from the findings of

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“…However, application of HLM stimulates discussion about how to solve system and process issues and improve quality and patient safety 22,60,68,74. Most of the analyzed papers have underscored the limits of HLM and barriers to its implementation,9,21,31,32,39,52,54,56,57,60,62,63,65,66,68,78 demonstrating that HLM can not be successfully implemented without considering the proper critical factors and precautions highlighted in the previous section of this paper.…”

Section: Resultsmentioning

confidence: 99%

Guidelines for overcoming hospital managerial challenges: a systematic literature review

Crema

Verbano

2013

TCRM

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PurposeThe need to respond to accreditation institutes’ and patients’ requirements and to align health care results with increased medical knowledge is focusing greater attention on quality in health care. Different tools and techniques have been adopted to measure and manage quality, but clinical errors are still too numerous, suggesting that traditional quality improvement systems are unable to deal appropriately with hospital challenges. The purpose of this paper is to grasp the current tools, practices, and guidelines adopted in health care to improve quality and patient safety and create a base for future research on this young subject.MethodsA systematic literature review was carried out. A search of academic databases, including papers that focus not only on lean management, but also on clinical errors and risk reduction, yielded 47 papers. The general characteristics of the selected papers were analyzed, and a content analysis was conducted.ResultsA variety of managerial techniques, tools, and practices are being adopted in health care, and traditional methodologies have to be integrated with the latest ones in order to reduce errors and ensure high quality and patient safety. As it has been demonstrated, these tools are useful not only for achieving efficiency objectives, but also for providing higher quality and patient safety. Critical indications and guidelines for successful implementation of new health managerial methodologies are provided and synthesized in an operative scheme useful for extending and deepening knowledge of these issues with further studies.ConclusionThis research contributes to introducing a new theme in health care literature regarding the development of successful projects with both clinical risk management and health lean management objectives, and should address solutions for improving health care even in the current context of decreasing resources.

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“Leaning” the Process of Venous Thromboembolism Prophylaxis

Cited by 17 publications

References 17 publications

A structured approach to improving patient safety: Lessons from a public safety-net system

A structured approach to improving patient safety: Lessons from a public safety-net system

Incidence-based cost estimates require population-based incidence data. A critique of Mahan et al.

Guidelines for overcoming hospital managerial challenges: a systematic literature review

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