Reducing postoperative venous thromboembolism complications with a standardized risk-stratified prophylaxis protocol...

Area of Science:

• Medical Interventions
• Patient Safety
• Surgical Outcomes

Background:

• Urban academic medical centers can experience high rates of postoperative venous thromboembolism (VTE).
• A need existed to implement and evaluate a standardized intervention to reduce VTE complications.

Purpose of the Study:

• To implement and determine the efficacy of a standardized intervention for reducing postoperative VTE complications.
• To assess the impact of a VTE prevention program on patient outcomes.

Main Methods:

• Developed a VTE reduction strategy using standardized electronic physician orders for early mobilization and mandatory Caprini risk stratification.
• Implemented electronic reminders for VTE prophylaxis and utilized mechanical and pharmacologic prophylaxis based on risk level.
• Conducted a before-and-after trial comparing National Surgical Quality Improvement Program (NSQIP) VTE outcomes pre- and post-intervention.

Main Results:

• Deep vein thrombosis incidence decreased by 84% (1.9% to 0.3%, p < 0.01).
• Pulmonary embolism incidence decreased by 55% (1.1% to 0.5%, p < 0.01).
• Risk-adjusted VTE outcomes improved significantly, with the odds ratio declining from 3.41 to 0.94 (p < 0.05).

Conclusions:

• A comprehensive patient care program integrating early mobilization, mandatory VTE risk stratification, and electronic prophylaxis recommendations effectively reduced VTE complications.
• The intervention demonstrated significant success in mitigating the likelihood of VTE events in surgical patients.