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Preventing VTE in hospitalised patients Dr Roopen Arya King’s College Hospital

Preventing VTE in hospitalised patients Dr Roopen Arya King’s College Hospital. Preventing VTE in hospitalised patients. Hospitalised patients at high risk of VTE VTE leads to substantial cost, mortality and morbidity

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Preventing VTE in hospitalised patients Dr Roopen Arya King’s College Hospital

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  1. Preventing VTE in hospitalised patientsDr Roopen AryaKing’s College Hospital

  2. Preventing VTE in hospitalised patients • Hospitalised patients at high risk of VTE • VTE leads to substantial cost, mortality and morbidity • Effective, safe and cost-effective measures to prevent hospital-acquired VTE exist • Roadmap is in place • Gap between current practice and optimal practice remains large Summary AHRQ report, 2008

  3. Thrombosis prevention in the UK

  4. VTE prevention: a global initiative

  5. Implementing national VTE guidance:progress • Implementation Working Group • Exemplar Centres • Thrombosis committees: local guidelines • Thrombosis teams • VTE Risk assessment

  6. VTE Implementation Working Group • Established by CMO • A Thomas (Chair), R Arya, T Baglin, A Flowerdew, A Kakkar, E Nicol, T Brown (Coordinator) • Provide oversight and leadership for implementation of national VTE strategy in the NHS and wider healthcare sector • Work closely with stakeholders such as NICE and HCC to ensure risk assessment of all hospitalised patients

  7. VTE Implementation Working Group • Develop a national VTE risk assessment tool • Develop Exemplar Centres • Raising awareness • Education

  8. Prevention of VTE in hospitalised patients: V Documented risk assessment for all hospitalised patients

  9. http://healthguides.mapofmedicine.com/

  10. Introduction of computer system

  11. VTE prevention: ‘real-world practice’ • ENDORSE survey: (2008) 52% patients at risk for VTE 50% receiving prophylaxis (surgical 59%; medical 40%) • APPTG survey:(APPTG 2nd Annual Audit, 2008) 99% acute Trusts were aware of CMO’s recommendations and NICE guideline 70% undertaking ‘documented mandatory risk assessment’ 86% have thrombosis committees 87% educate staff re: risk of VTE • VERITY survey: 94% have thrombosis committees >80% have guidelines for medical and surgical thromboprophylaxis <10% to 95% patients risk assessed for VTE 1 in 8 using DH VTE risk assessment

  12. VTE Exemplar Centres • Resource for demonstration of best practice • Based within hospitals or networks with an existing track record of excellent VTE management • Expanded role including quality control, audit and education • Help develop national risk assessment strategy, audit tools, centralised educational material to support local programmes • King’s College Hospital was first NHS exemplar centre & the London Clinic in the independent sector • Network of exemplar centres being developed: 8 exemplar centres at end of 2008

  13. VTE Exemplar Centres: Requirements • Chief Executive agreement / support • Mechanism in place for VTE risk assessment • Audit trail – evidence of prevention management across organisation • Multidisciplinary team approach • Education and raising awareness re: VTE • Ability to act as a resource to spread good practice • To apply e-mail: roopen.arya@kcl.ac.uk

  14. VTE exemplar centres: main elements • Thrombosis committees • Thrombosis teams • Implementation of VTE risk assessment and thromboprophylaxis • Audit • Education and awareness • Clinical research into VTE

  15. VTE exemplar centres in action: Models of care: • Excellence at prevention of VTE in hospitalised patients • Comprehensive care of VTE • VTE prevention in the community Exemplars will include: • NHS Hospital Trusts • Primary Care Trusts • Strategic Health Authorities • Independent sector

  16. VTE Exemplar Centres

  17. Exemplar centres: education and awareness • Local activities and training • E-learning modules http://www.elearning-essexrivers.co.uk http://doctors.net.uk/education e-Learning for Healthcare VTE module: in progress • Lecturing at national courses on thromboprophylaxis: Hertfordshire & Birmingham • NHS Choices: video on DVT http://www.nhs.uk/video

  18. Exemplar centres: education and awareness • Meetings and workshops: • VTE awareness symposium at the London Clinic • 26th Sept 2008 • - First national VTE exemplar centre study day • 18th March 2009 at the Royal Society of Medicine • VTE, a key patient safety issue: Patient Safety Congress 1st May 2009 @ the ICC, Birmingham • Workshops for nurses and pharmacists planned

  19. VTE exemplar centre websitewww.kingsthrombosiscentre.org.uk

  20. Developing a systems-based approach to the prevention of VTE in hospitalised patients Patient admitted to hospital What will success look like? Professional workforce aware of VTE risk Individual patient risk assessed for VTE Appropriate preventative strategy implemented Evaluation of outcome

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