Using the Safer Clinical Systems approach and Model for Improvement methodology to decrease Venous Thrombo-Embolism...

Area of Science:

• Healthcare Improvement
• Patient Safety
• Surgical Care

Background:

• High incidence of post-procedural deep vein thrombosis (DVT) and pulmonary embolus (PE) identified.
• Unreliable peri-operative processes led to incorrect or missed venous thromboembolism (VTE) prophylaxis.
• Previous use of "Safer Clinical Systems" methodology in a similar project.

Purpose of the Study:

• Apply "Safer Clinical Systems" methodology to improve VTE prophylaxis.
• Develop and implement a new process for VTE risk assessment and prophylaxis.
• Reduce hospital-associated VTE in surgical patients.

Main Methods:

• Utilized "Safer Clinical Systems" and Model for Improvement methodologies.
• Collaborated with stakeholders to develop a new VTE risk assessment process.
• Integrated VTE checks into the WHO Surgical Safety Checklist and developed standardized operation notes.

Main Results:

• Achieved 100% completion of VTE risk assessments for elective surgical patients on admission (baseline 40%).
• Standardized mechanical prophylaxis and stockings resulted in a £52,000 cost saving.
• Reduced hospital-associated thrombosis by 80% and overall VTE by 88% between January 2014 and December 2015.

Conclusions:

• The implemented VTE prophylaxis process significantly improved patient safety.
• The "Safer Clinical Systems" methodology is adaptable to different healthcare contexts.
• Sustained improvements in VTE prevention were achieved through process redesign and education.