Working toward a System-wide Venous Thromboembolism Prophylaxis Strategy: Experience from a Multisite Health Region

Abstract

Background Venous thromboembolism (VTE), comprised of both deep vein thrombosis (DVT) and pulmonary embolism (PE), is a common complication for hospitalized patients. Clear guidance is available to practitioners in regard to risk factors for the development of VTE as well as strategies to decrease its prevalence. Despite knowing who is at risk and how to prevent VTE, practitioners provide adequate measures to only half of the patients who are eligible for VTE prophylaxis. Pharmacy practitioners within the Regina Qu'Appelle Health Region (RQHR) have been actively involved in improving VTE prophylaxis for inpatients over the past 10 years. Objective To improve the rate of VTE prophylaxis within the RQHR, thereby improving patient safety. Methods The strategy involved 3 phases: a preparation phase, an active intervention phase, and a maintenance and improvement phase. The preparation phase included education and participation in a national registry along with a residency project. The intervention phase consisted of a number of strategies in conjunction with 1-day VTE prophylaxis audits, and the maintenance phase consisted of ongoing educational initiatives and audits. Results From January 2005 to January 2009, the percentage of patients being appropriately managed for VTE prophylaxis within the RQHR improved from 62% to 94% ( P < .005). Looking specifically at our medical and surgical populations, rates increased from 47% to 90% ( P < .005) and 79% to 97% ( P < .005), respectively. Conclusion The strategy was successful in improving VTE prophylaxis in the inpatient population.