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.

Venous thrombosis control chart

By ensuring the appropriate anticoagulant prophylaxis dose was given, the VTE rate for the health system was reduced by 58% since 2014.

Venous thrombosis decrease control chart

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