IMPROVING VTE RISK ASSESSMENT IN HOSPITALISED PATIENTS IN A TERTIARY CARE HOSPITAL IN IRELAND

Area of Science:

• Healthcare Quality Improvement
• Clinical Audit
• Patient Safety

Background:

• Baseline audit revealed only 24% of hospitalized patients had documented venous thromboembolism risk assessment (VTE-RA).
• This highlighted an urgent need to enhance VTE-RA practices in hospital settings.
• A quality improvement project (QIP) was initiated to achieve 90% compliance with VTE-RA tool completion.

Purpose of the Study:

• To implement and evaluate a quality improvement project (QIP) aimed at increasing the documentation of VTE-RA and prescription of pharmacological thromboprophylaxis (TP).
• To embed the VTE-RA process into routine clinical practice within a tertiary referral hospital.

Main Methods:

• A single-centre, before-and-after study with a prospective cross-sectional design was conducted.
• Intervention included developing a TP policy, VTE-RA tool, education, and monthly audits using Plan-Do-Study-Act (PDSA) cycles.
• Data on VTE-RA documentation and TP prescription were collected from adult inpatients.

Main Results:

• VTE-RA documentation improved significantly from 24% to 57% (p <0.001).
• Prescription of pharmacological TP increased significantly from 43% to 67% (p<0.001).
• The greatest improvement in VTE-RA was observed in high-risk thrombosis patients, increasing from 21.9% to 61%.

Conclusions:

• The introduction of a TP policy and VTE-RA tool led to a 33% increase in compliance.
• Current achievements are unsustainable without a dedicated multidisciplinary thrombosis team.
• Attaining 90% compliance with VTE-RA is unlikely without ongoing dedicated team involvement.