Figure 1. Sequence and Relationship of Steps in a Quality Improvement Project Aimed at Reducing the Incidence of Hospital-Acquired Venous Thromboembolism
This flow chart depicts the five steps that quality improvement teams should take if they want to reduce the incidence of hospital-acquired venous thromboembolism (VTE).
Step 1 is to draft a VTE protocol, which provides decision support for risk stratification plus a menu of appropriate prophylaxis options for each level of risk. Step 2 is analyze care delivery. Step 3 is set up performance tracking. Step 4 is introduce the VTE protocol then augment it with other high reliability quality improvement (QI) strategies. Step 5 is to perfect quality improvement strategies and performance tracking through cycles of plan-do-study-act.
In this chart, steps one through three appear in boxes on the left side. An arrow to the right of step one points to two boxes VTE protocol and high reliability QI strategies. A box with the words "evidence base" appears on top of the VTE protocol box to show that the evidence base is used to develop the protocol.
An arrow to the right of step two points to three parallel boxes with the words "care delivery" in each.
An arrow to the right of step three points to one box that contains the words "performance tracking".
Arrows beneath the boxes VTE protocol and high reliability QI strategies also point to the boxes that contain the words "care delivery."
At the very bottom of the flow chart, a notional scatterplot shows the key metric of the rate of appropriate VTE prophylaxis. It has data points ranging from less than 40 percent to nearly 100 percent. The concept it shows is that, as the QI project advances to steps four and five, more patients will receive appropriate prophylaxis.
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