Decrease Venous Thrombosis
Decrease Venous Thrombosis (VTE) by 25%
Venous thromboembolism (VTE), including deep vein thrombosis (DVT) and
pulmonary embolism (PE), is a major cause of morbidity and mortality,
occurring in up to 1 million people and accounting for over 200,000 deaths
annually in the USA. Importantly, more than half of VTE cases are attributable
to the hospital or surgical setting. Pharmacologic thromboprophylaxis
(e.g., heparin, low-molecularweight heparin [LMWH], NOACs and fondaparinux)
has been shown to substantially reduce this risk of VTE in both medical
and surgical populations. Obesity, including morbid obesity, is associated
with a high risk of VTE and, unfortunately, fixed doses of US FDA-approved
anticoagulant regimens; including unfractionated heparins, low-molecular-weight
heparins and factor Xa inhibitors may not provide optimal VTE prophylaxis
in these patients. The Acute Care Service Line implemented a dosing program
to ensure that the appropriate prophylaxis dose was calculated for all
patients based on their weight. The baseline appropriate prophylaxis dose
was 60% prior to Oct 2014. This initiative was started in Oct 2014 and
through Dec 2016 our patients now receive the appropriate prophylaxisdose
96% of the time.
The Pharmacy Enterprise migrated to measuring quality initiatives in a
control chart methodology. The graphs displayed below are control charts,
used to study how a process changes over time. Data are plotted chronologically.
A control chart always has a central line for the average (highlighted
in red), an upper line for the upper control limit (highlighted in green)
and a lower line for the lower control limit (highlighted in purple).
These lines are determined from historical data.
By ensuring the appropriate anticoagulant prophylaxis dose was given, the
VTE rate for the health system was reduced by 58% since 2014.