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Do Decision Support Tools Decrease the Prevalence of Hospital-Acquired Venous Thromboembolisms When Compared to

Mohammad Abdulelah1, Omar Haider1, Matthew McAuliffe1

  • 1Department of Internal Medicine, University of Massachusetts Chan Medical School-Baystate Regional Campus, Springfield, MA 01199, USA.

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PubMed
Summary

Implementing a mandatory decision support tool (DST) for hospital-acquired venous thromboembolism (HA-VTE) prophylaxis did not significantly change HA-VTE incidence or patient length of stay. Healthcare professionals reported dissatisfaction and workflow disruption with the DST.

Keywords:
decision support toolhospital-acquired venous thromboembolismsrisk assessment model

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Area of Science:

  • Medical Informatics
  • Patient Safety
  • Health Services Research

Background:

  • Hospital-acquired venous thromboembolisms (HA-VTEs) pose significant patient and financial burdens.
  • Current VTE prophylaxis relies on perceived risk via order sets, but standardized risk assessment models are recommended.
  • Decision support tools (DST) integrating risk models can improve prophylaxis but may cause healthcare professional fatigue.

Purpose of the Study:

  • To evaluate the impact of a mandatory DST on HA-VTE incidence and length of stay.
  • To assess healthcare professional satisfaction with the implemented DST.

Main Methods:

  • Retrospective, pre-post-implementation observational study at a tertiary medical center.
  • Utilized Padua and Caprini scores within a mandatory DST for medical and surgical patients, respectively.
  • Collected data via ICD-10 codes and electronic charts; surveyed healthcare professionals anonymously.

Main Results:

  • No statistically significant difference in HA-VTE incidence per 1000 discharges per month pre- and post-DST implementation (4.4 vs. 4.6).
  • Hospital length of stay remained unchanged (14.2 days pre- vs. 14.1 days post-implementation).
  • High dissatisfaction reported by 84% of surveyed professionals, with 91% indicating it slowed their workflow.

Conclusions:

  • Mandatory DST implementation did not alter HA-VTE prevalence, length of stay, or readmission rates compared to previous risk-based order sets.
  • Further research is needed to refine risk assessment models and enhance DST usability and satisfaction for healthcare professionals.