St. Mark's Hospital - May 11, 2017

The VTE reduction team lead by Dr. Chris Robison, chief medical officer, is collaborating with the Hip & Knee Replacement Program team led by its medical director, Dr. Jeff Jackson, to target reduction in venous thromboembolism (deep vein thrombosis and pulmonary embolus) in patients admitted to 5West. Our goal is ZERO VTE DEATHS, and at least a 50% reduction in hospital-acquired VTE cases.

The graph that follows demonstrates our hospital-wide VTE rates and VTE deaths since 2013.

Our 2016 data reveals that the occurrence of pulmonary embolism is approximately twice that of deep vein thrombosis.

2016 VTE: DVT vs. PE

VTE occurred most frequently in 2016 on 5 West and 4 West.

VTE deaths since 2013 have been most frequent on 5 West, 4 West and PCU.

In 2016, VTE most frequently occurred on our general orthopedic and ortho/spine services.

Since 2013, VTE deaths have occurred most frequently on our general orthopedic, hospitalist and ortho/spine services.

In 2016, our VTE occurrences were almost twice as often in immobilized patients or patients at bedrest.

In 2016, most of our VTE occurrences took place in patients on sequential compression devices (SCDs) or TED hose.

In 2016, about half of our VTE’s occurred in patients not on anti-coagulants.

In 2016, all three of our VTE deaths occurred in patients with a Caprini Score of 9 or greater.

The following diagram has been derived from the validated VTE risk scoring system devised by Dr. Joseph Caprini at the University of Michigan.

  • Risk points are shown within the colored circles, with the highest risk assigned to patients who are inactive due to orthopedic surgery, multiple trauma, acute paralysis, and stroke.
  • Age, a family history of thrombosis, congenital and acquired hypercoagulable states, and prior history of DVT or PE are also major risk factors.

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