Improving Venous Thromboembolism Prophylaxis

Mayo Clinic

Status and phase: Completed; Phase 4

Conditions: Quality Improvement; Delivery of Health Care; Venous Thromboembolism

Treatments: Other: BLAZE Pop up; Other: Usual Care; Other: VTE-P Tollgate

Study type: Interventional

Funder types: Other

Identifiers

NCT01304108

09-006359

Details and patient eligibility

About

Preventing the formation of blood clots in the veins so they do not injure leg veins or travel to the lungs, also called venous thromboembolism prophylaxis (VTE-P) is an essential component of safe in-patient care, yet it is deployed sub-optimally in many hospitals, including The investigators own. Two prior VTE-P improvement projects were completed at Mayo Clinic hospitals, one in the Department of Medicine, and the other in selected divisions of the Department of Surgery. Both projects resulted in marked improvement in the percentage of patients receiving appropriate VTE-P. This project seeks to utilize the lessons learned from these two pilots along with known best practices for "spreading" to deploy methods that enhance VTE-P to the entire hospitalized population. The investigators seek appropriate VTE-P rates exceeding 95%.

Full description

Venous thromboembolism prophylaxis (VTE-P) is an essential component of safe in-patient care, yet it is deployed sub-optimally in many hospitals, including our own. Two prior VTE-P improvement projects were completed at Mayo Clinic hospitals, one in the Department of Medicine, and the other in selected divisions of the Department of Surgery. Both projects resulted in marked improvement in the percentage of patients receiving appropriate VTE-P. This project seeks to utilize the lessons learned from these two pilots along with known best practices for "spreading" to deploy methods that enhance VTE-P to the entire hospitalized population. The investigators seek appropriate VTE-P rates exceeding 95%. This began as a quality improvement project. The investigators have taken baseline measures of VTE-P rates in our hospitals, intervened with various electronic prompts to use appropriate VTE-P, and have and will re-measure VTE-P rates. The investigators intend to present and publish our methods and results so that lessons learned may be shared and applied elsewhere.

Enrollment: 3,000 patients

Sex: All

Ages: 17+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Inpatients with age > 17 years old

Exclusion criteria

• Outpatients
• Inpatients with age less than or equal to 17 years old

Trial design

Primary purpose: Health Services Research

Allocation: Non-Randomized

Interventional model: Single Group Assignment

Masking: None (Open label)

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3,000 participants in 3 patient groups

Order Set

Experimental group

Description:

Insertion of VTE-P Order Set "tollgate" in all active admission and transfer orders.

Treatment:

Other: VTE-P Tollgate

Clinical Decision Support Pop-up

Experimental group

Description:

Deploy rules-based pop-up that reminds ordering clinicians when patients do not have an active VTE-P plan.

Treatment:

Other: BLAZE Pop up

Usual Care

Active Comparator group

Description:

Usual care, without the experimental additions

Treatment:

Other: Usual Care