Category Ranking
98%
Total Visits
921
Avg Visit Duration
2 minutes
Citations
20
Article Abstract
Objective: We studied a collaborative-wide quality improvement project (CQIP) focused on improving postdischarge venous thromboembolism (VTE) chemoprophylaxis adherence. We aimed to identify patient-level characteristics associated with adherence, evaluate differences in adherence rates among participating hospitals, and assess facilitators and barriers to adherence at high- and low-performing hospitals.
Background: VTE is the most common preventable cause of death after abdominopelvic cancer surgery, yet adherence to guideline-recommended postdischarge VTE chemoprophylaxis remains suboptimal. A CQIP including audit and feedback of performance data, a toolkit, coaching calls, and best practice alerts was implemented.
Methods: Patients undergoing inpatient abdominopelvic cancer surgery at a CQIP-enrolled hospital during a 3-year study period were included. Unadjusted and adjusted rates were calculated for postdischarge VTE chemoprophylaxis adherence. High performance was defined as >10% improvement and/or ≥80% adherence. We conducted semistructured interviews and focus groups with collaborative members to identify barriers and facilitators to implementation.
Results: Postdischarge VTE chemoprophylaxis adherence increased from 51.8% (preimplementation) to 64.5% (postimplementation; < 0.05). Patients who underwent urologic (odds ratio [OR], 1.76 [95% CI, 1.27-2.43]) and gynecologic procedures (OR, 3.90 [95% CI, 2.73-5.58]) were more likely prescribed appropriate VTE chemoprophylaxis compared with colorectal procedures. Eight hospitals (50%) had improvement in adherence rates, and 8 (50%) were high performers. Barriers to implementation included a lack of surgeon buy-in, technical challenges, and a lack of awareness.
Conclusions: A CQIP was associated with increased postdischarge VTE adherence rates. Different barriers exist between high- and low-performing hospitals. Future collaborative work should focus on hospital-level interventions to improve low-performer results.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11932594 | PMC |
| http://dx.doi.org/10.1097/AS9.0000000000000555 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Sisyphus' Alert: The Uphill Struggle to Improve Venous Thromboembolism Prophylaxis Clinical Decision Support.
Appl Clin Inform
August 2025
Information Technology Services, UW Medicine, Seattle, Washington, United States.
Chemoprophylaxis reduces the risk of hospital-acquired venous thromboembolism (VTE), but is not reliably ordered. Our institution created a clinical decision support (CDS) interruptive alert to remind clinicians to order VTE chemoprophylaxis when it is missing for qualifying inpatients. Unfortunately, this alert has required repeated modifications to ensure accurate logic, and continues to generate negative feedback from users.
View Article and Find Full Text PDFBattling the Conundrum of Bleeding and Clotting: Initiation of Venous Thromboembolism Prophylaxis in Traumatic Brain Injury after Neurosurgical Intervention.
J Am Coll Surg
September 2025
Institute for Research on Equity and Community Health (iREACH), ChristianaCare Health System, Wilmington DE.
Background: There are no consensus guidelines demonstrating early venous thromboembolism prophylaxis (VTEP) is safe in patients with traumatic brain injury (TBI) who underwent neurosurgical interventions. We hypothesized that early initiation of VTEP in TBI patients would decrease the incidence of venous thromboembolism (VTE) and intracranial hemorrhage expansion (ICHE).
Study Design: A retrospective single center study of adult TBI patients who underwent neurosurgical intervention from 2012-2023 at a level 1 trauma center.
Cost-Effectiveness Thresholds for Venous Thromboembolism Prophylaxis in Ankle Fracture Surgery: A Break-Even Analysis.
Foot Ankle Orthop
July 2025
Rutgers New Jersey Medical School, Newark, NJ, USA.
Background: The role of venous thromboembolism (VTE) chemoprophylaxis following ankle fracture surgery remains controversial. Although pharmacologic prophylaxis is standard in major orthopaedic procedures, its utility in foot and ankle trauma surgery is unclear because of low reported VTE rates and potential bleeding risks. Furthermore, no consensus exists on the cost-effectiveness of prophylactic agents in this population.
View Article and Find Full Text PDFThromboprophylaxis for Prevention of Venous Thromboembolism: Practice Patterns Among American Head and Neck Society Members.
Ann Otol Rhinol Laryngol
August 2025
Department of Otolaryngology, SUNY Upstate Medical University, Syracuse, USA.
Objectives: VTE is associated with significant morbidity and is the most common cause of preventable death in hospitalized patients. Although there are no society-specific guidelines for VTE prevention in otolaryngology, there is evidence to support routine use of chemoprophylaxis in high-risk patients. The objective of this study is to evaluate current methods of perioperative thromboprophylaxis.
View Article and Find Full Text PDFVenous thromboembolism after ventral hernia repair with transversus abdominis release.
Surg Endosc
July 2025
Department of General Surgery, Digestive Disease Institute, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH, 44195, USA.
Introduction: Venous thromboembolism (VTE) events, such as pulmonary embolism (PE) and deep venous thrombosis (DVT), are a significant source of morbidity and mortality after major abdominal wall reconstruction. We aim to describe the incidence of VTE events in patients undergoing ventral hernia repair (VHR) with transversus abdominis release (TAR) at our institution.
Methods: The Abdominal Core Health Quality Collaborative registry was queried for patients, 18 years and older, who underwent VHR with TAR at our institution between August 2014 and December 2023.