SHM Launching VTE Reduction Collaborative

At Emory, the Measure-vention strategy was adopted in 2009 as the final piece of the VTE prevention program, which started in 2006. Patients are color coded on a “dashboard” that is refreshed hourly. Red means no prophylaxis ordered, yellow means mechanical only has been ordered, and green means the patient is receiving a pharmacologic agent.

Six months after it was implemented, the dashboard helped pull prophylaxis rates above 90% in the 15 inpatient units at Emory University Hospital that were using the strategy, triple the rate before the dashboard, Dr. Stein said.

A year after starting the real-time monitoring in 2008, one 20-bed intensive care unit had a 75% reduction in potentially preventable hospital-acquired VTE, “attributable to a similarly significant rise in VTE prophylaxis from 73% to 94%,” he said.

There were nine fewer clots in that unit, which “represents real morbidity prevention and real cost savings, and very possibly represents preventable deaths from pulmonary embolism,” he said.

The implementation of the dashboard – which is now available to nurses and physicians at five Emory hospitals – has created new channels of communication between clinical and information services and contributed to an increased sense of pride in frontline nurses and clinicians, Dr. Stein observed.

“Ultimately, we’ve developed a new mindset for how performance is measured and improved at Emory,” he said.

Emory was recognized at the SHM annual meeting in April with an Excellence in Teamwork in Quality Improvement Award.

SHM hopes that other facilities can replicate the Emory experience. It has enrolled 80 facilities in the Prevention Collaborative.

Dr. Maynard said that awareness may also increase throughout the Department of Veterans Affairs, which initially had six hospitals take part in a pilot that he and Dr. Stein helped launch. Now, “many, many sites in the VA” are using the VTE prevention toolkit, he said.

The IHI and AHRQ also have enrolled dozens of hospitals in collaborations to reduce VTE.

VTE prophylaxis has been “suboptimal for a long time,” said Dr. Maynard. But, “it’s getting there.”