Interventional bundle for venous thromboembolism prevention: ensuring quality and effectiveness.

Area of Science:

• Healthcare Management
• Patient Safety
• Clinical Audit

Background:

• Hospital-associated thromboses (HATs) represent a significant, preventable cause of patient morbidity and mortality.
• Previous VTE prevention audits at Oxford University Hospitals NHS Foundation Trust revealed limitations and potential under-reporting of HATs.
• A need was identified to improve VTE prevention data quality and reduce preventable HATs.

Purpose of the Study:

• To enhance data quality for key VTE prevention measures.
• To identify areas for improvement in VTE prevention strategies.
• To reduce the incidence of potentially preventable HATs over a two-year period.

Main Methods:

• Implementation of a multifaceted interventional bundle using 'Plan Do Study Act' cycles.
• Engagement with hospital leadership and collaboration with hospital-wide stakeholders.
• Continuous evaluation of intervention impact on VTE prevention measures.

Main Results:

• Appropriate thromboprophylaxis for inpatients increased from 94% to 98%.
• The secondary aim of reducing potentially preventable HATs was not met.
• Revision of HAT reporting led to better detection and initial increase in reporting, with subsequent reduction in harm.

Conclusions:

• A coordinated, low-cost interventional bundle significantly improved VTE management and patient safety.
• Robust audits, pharmacist upskilling, and improved electronic prescribing integration contributed to enhanced VTE prevention.
• The developed model for VTE management is sustainable and replicable in other healthcare settings.