J Clin Outcomes Manage
Venous thromboembolism prophylaxis and the impact of standardized guidelines: is a computer-based approach enough?
Quraishi MB, Mathew R, Lowes A, Bashir CM, Markert RJ
ABSTRACT: Objective: To determine the frequency of venous thromboembolism (VTE) prophylaxis and the incidence of VTE before and after the implementation of computer-based prophylaxis guidelines based on the American College of Chest Physicians (ACCP) recommendations. Methods: Using a retrospective chart review, we stratified 1406 Veterans Affairs Medical Center patients with multiple risk factors into 3 risk categories (high, intermediate, and low) and determined the frequency of VTE prophylaxis and the VTE rate before and after the implementation of ACCP guidelines. Results: Before the guidelines were implemented, appropriate VTE prophylaxis was used in 401 of 701 (57.2%) patients. After implementation, appropriate prophylaxis was used in 549 of 705 (77.9%) (P < 0.001). The frequency of VTE before guideline implementation was 1.4% (10 cases) while after implementation the rate was 1.2% (8 cases) (P = 0.54). Conclusion: The implementation of computer-based guidelines improved VTE prophylaxis. Electronic alerts and physician education regarding VTE prevention are needed to improve physician compliance and the appropriate selection of prophylaxis.
Search the Turner White index to find abstracts of articles published in JCOM.