The 2016 Physician Engagement Survey identified “Initiatives to Improve Patient Care Relative to Safety Issues” as the aspect which most influences physician’s perceptions of patient safety. Dr. Chris Robison, chief medical officer, is advocating that we target the prevention of venous thromboembolism. While major improvements have been made at St. Mark’s Hospital since 2013 in the incidence of VTE associated with the improvements in early ambulation and the use of sequential compression devices (50 cases of VTE in 2013 vs. 18 cases in 2015), the reduction in incidence appears to have plateaued in 2015 and begun to increase again in 2016.
Venous thromboembolism is the most common preventable cause of hospital death; the burden of VTE includes the management of the acute event (deep vein thrombosis [DVT]/pulmonary embolism) and the chronic sequelae such as post-thrombotic syndrome and recurrent DVT. All experts agree that despite the abundance of knowledge available on VTE and how to prevent it, it is still underused, and since the first step in prophylaxis is to identify those who are at high risk of VTE, several risk assessment models have been developed to identify these patients and provide guidance on appropriate prophylaxis. Among these are the American College of Chest Physicians (ACCP – 9th Edition) guideline and the Caprini risk scoring system and treatment algorithm.
In early 2017, Dr. Robison will assemble a physician advisory group to review current VTE prevention practices in the hospital and current literature on VTE risk assessment for the purpose of achieving greater consensus on our approach to VTE prevention at St. Mark’s.
Physicians interested in participating in this advisory group should contact Dr. Robison at (801) 268-7149.
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