Inventive ways of identifying and treating patients with health care associated venous thromboembolism (HA-VTE) have garnered awards for 8 hospitals and health care systems in the HA-VTE Prevention Challenge, sponsored by the CDC.
The winners range from small community hospitals to large health care systems: Mayo Clinic, University of California Health, Center for Health Quality and Innovation; University of Wisconsin Health (Madison); Intermountain Healthcare (Murray, UT); Northwestern Memorial Hospital (Chicago); Johns Hopkins Hospital (Baltimore); Harborview Medical Center (Seattle); and Hutchinson (KS) Regional Medical Center.
All improved VTE prevention with innovative, effective, and sustainable initiatives and strategies.
Harborview Medical Center (HMC) developed an electronic tool for efficient, standardized review of HA-VTE. The tool uses natural language processing, allowing the HMC VTE Task Force to quickly gauge the accuracy of risk assessment and appropriateness of prophylaxis. It also developed tools to provide real-time, actionable information at the bedside, including lists that highlight patients who have not received chemical or mechanical prophylaxis in 24 hours. Those who have received vitamin K antagonists are identified to ensure patient/family education and appropriate follow-up. Treatment data “snapshots” are embedded in resident physician and nursing handoff tools to enhance multidisciplinary communication. All process and outcome measures are displayed on an internal web-based dashboard, with improvement opportunities highlighted.
As a result, HMC has had zero potentially preventable VTE events since the measure was implemented in January 2013—a national best practice. Improved VTE prophylaxis contributed to a 15% reduction in HA-VTE between 2011 and 2015. Among postoperative patients, the rate of VTE dropped 21%. Diagnosis, treatment, patient education, and outpatient follow-up have all improved. Moreover, HMC says, the lessons learned have formed the basis of ongoing improvement initiatives.
Four entrants (“Unique Populations and Interventions”) received honorable mentions: Michigan Hospital Medicine Safety Consortium, Ann Arbor; Sheppard Pratt Health System, Baltimore; Rotunda Hospital, Dublin, Ireland; and University of Cincinnati Medical Center.