Improving the quality of care for patients at risk for venous thromboembolism

To describe risk factors for venous thromboembolism (VTE), quality improvement efforts for VTE prevention, and strategies health-system pharmacists can use to improve anticoagulant use and outcomes in patients at risk for VTE.

Risk factors for VTE involve the presence of one or more components of Virchow's triad (endothelial injury, circulatory stasis, and hypercoagulable states) and are exceedingly common in hospitalized patients. Several effective methods for VTE prophylaxis are readily available but remain underused. Quality improvement initiatives to improve VTE prophylaxis rates include evidence-based clinical practice guidelines, mandatory practice and outcomes reporting, and pay-for-performance requirements. The development and implementation of VTE risk assessment tools and treatment algorithms, protocols, policies, and procedures are among the strategies that health-system pharmacists can use to improve anticoagulant use and quality of care in patients at risk for VTE.

The use of anticoagulant therapy presents health-system pharmacists with both challenges and opportunities to improve the quality of care in patients at risk for VTE.