Quality improvement program: advancement of hospital venous thromboembolism--free zones

Venous thromboembolism is a frequent complication of total hip or total knee arthroplasty, with serious clinical and economic consequences. It is largely preventable with adherence to evidence-based guidelines for thromboprophylaxis. Nevertheless, many clinicians are either unaware of the serious consequences of venous thromboembolism or skeptical of the value of the guidelines. Now, however, government and quality agencies are stepping in with new initiatives that affect reimbursement for preventable events and are designed to reduce the number of thromboembolic events that occur as the result of insufficient or no prophylactic therapy. The development of new oral anticoagulants will play an important role in increasing the effectiveness, safety, and convenience of thromboprophylactic therapy, which may improve adherence to guidelines for thromboprophylaxis.