Preventing Hospital-Acquired Venous Thromboembolism

A Guide for Effective Quality Improvement

Pulmonary embolism resulting from deep vein thrombosis—collectively referred to as venous thromboembolism—is the most common preventable cause of hospital death. Pharmacologic methods to prevent venous thromboembolism are safe, effective, cost-effective, and advocated by authoritative guidelines, yet large prospective studies continue to demonstrate that these preventive methods are significantly underused. Based on quality improvement initiatives undertaken at the University of California, San Diego Medical Center and Emory University Hospitals, this guide assists quality improvement practitioners in leading an effort to improve prevention of one of the most important problems facing hospitalized patients, hospital-acquired venous thromboembolism.

This project was funded under grant number Grant No. 1U18 HS015826-01 from the Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services.


Prepared by: Society of Hospital Medicine; Greg Maynard M.D., M.Sc. University of California, San Diego Medical Center; and Jason Stein, M.D., Emory University Hospitals. 

Contents

Acknowledgments
Copyright Information and Disclaimer
Preface
Chapter 1. Take Essential First Steps
Chapter 2. Lay Out the Evidence and Identify Best Practices
Chapter 3. Analyze Care Delivery
Chapter 4. Track Performance With Metrics
Chapter 5. Layer Interventions
Chapter 6. Continue to Improve
 

Appendixes
Appendix A. Talking Points to Attract Administration Support for Venous Thromboembolism Prevention Programs
Appendix B. Sample Venous Thr omboembolism Protocol/Order Set
Appendix C. Suggested Reading for Venous Thromboembolism Protocol Development
Appendix D. Chart Audit Form 44

Glossary
References 

Acknowledgments

For manuscript review, we also are deeply indebted to Kathleen Kerr, Tina Budnitz, and the members of the Hospital Quality and Patient Safety Committee of the Society of Hospital Medicine. 

Disclaimer and Copyright Information

No investigators have any affiliations or financial involvement (e.g., employment, consultancies, honoraria, stock options, expert testimony, grants or patents received or pending, or royalties) that conflict with material presented in this report.

This document is in the public domain and may be used and reprinted without special permission. Citation of the source is appreciated.

Ordering Information

This guide (AHRQ Publication Number 08-0075) can be ordered through the Publications Clearinghouse by calling 800-358-9295. From outside the United States, call 703-437-2078. Toll-free TDD services for the hearing impaired are available by calling 888-586-6340. Email requests for AHRQ Publication Number 08-0075 may be made to AHRQpubs@ahrq.hhs.gov. Mailed requests can be sent to AHRQ Publications Clearinghouse, Re: AHRQ Publication No. 08-0075, P.O. Box 8547, Silver Spring, MD 20907.

Page last reviewed August 2008
Internet Citation: Preventing Hospital-Acquired Venous Thromboembolism: A Guide for Effective Quality Improvement. August 2008. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/quality-patient-safety/patient-safety-resources/resources/vtguide/index.html