SHM VTE Prevention Collaborative

The Application for the VTE Mentor Implementation is Now Open!

Get tools and long-term mentoring support to decrease your patients' incidence of preventable hospital acquired VTE. Read below to find out how to participate.

SHM is now accepting applications for the VTE Prevention Collaborative (VTE PC), a program that offers individualized assistance to hospitalists wishing to take the lead on this critical quality and patient safety issue. Apply now to participate in SHM's innovative program that includes scheduled telephone calls with expert mentors, email support, and opportunities for peer learning.

Applications are being accepted for the fall cohort which will launch October 2010. Applications must be submitted by September 30th, 2010. Completing the application will take about 30 minutes. Space is limited, so we recommend applying early.

SHM members can apply by visiting the VTE Prevention Collaborative Application Website.

What is Mentored Implementation?

The Problem of Hospital-acquired Venous Thromboembolism (VTE)

Venous thromboembolic disease, ranging from asymptomatic deep vein thrombosis (DVT) to massive pulmonary embolism (PE), is a significant cause of morbidity and mortality in hospitalized patients. Almost all hospitalized patients are at risk for VTE and the literature suggests that approximately half of all VTE's are hospital-acquired.^1-4 PE is recognized as the cause of death for more than 100,000 hospitalized patients in the Unites States every year, and is considered a contributing factor in the death of 100,000 more patients.¹
Multiple clinical trials have provided irrefutable evidence that primary thromboprophylaxis reduces the incidence of DVT and PE.⁵ Unfortunately, numerous studies have also shown that the majority of hospitalized patients with risk factors for DVT do not receive appropriate prophylaxis.^6-8

Hospitalists are ideally positioned to reduce the incidence of preventable VTE's, both by using known best-practices to improve care delivered to their own patients, and, more importantly, by leading hospital-wide QI efforts that improve care for all patients at their home institutions.

The VTE PC Program

SHM mentors with VTE and QI expertise will provide participants with practical assistance on topics central to designing, evaluating, implementing and sustaining a VTE prevention program. Participants will receive assistance with:

• Securing institutional support for the project
• Assembling and leading the project team
• Developing goals and aims for the project
• Mapping the current processes for assessing VTE and bleeding risk and administering prophylaxis
• Evaluating the evidence and incorporating it into local risk assessment and prophylaxis recommendations
• Redesigning care delivery processes to include high-reliability features that promote adherence to best practices
• Developing and implementing educational/outreach plans to ensure buy-in from key stakeholders
• Collecting, analyzing and reporting outcome data
• Identifying patients appropriate for post-discharge prophylaxis and exploring processes for ensuring continued administration of appropriate prophylaxis

Mentors will work with each participant to tackle site-specific issues using proven QI techniques. Mentoring will occur during scheduled telephone calls offered over a 15-18 month period. Instruction will be organized around the VTE QI Implementation Guide, SHM's step-by-step guide for developing a VTE prevention program. (The Workbook can be viewed and downloaded from the VTE Resource Room.)

Applying to the Programs

Participation in the program is open to hospitalists who are leading or participating in proposed or active VTE prevention programs. We welcome participation from hospitalists who work in all types of facilities (large and small community hospitals, academic medical centers, public hospitals, etc.) and all types of practice settings (acute care hospitals, skilled nursing facilities, rehabilitation hospitals, etc.) The program is appropriate for individuals with all levels of QI experience, from the novice embarking on his or her first QI project to the seasoned QI leader. Individuals who have not yet begun working on a VTE prevention project are encouraged to apply, as are those who wish to expand or improve upon an existing project.

SHM members can apply by visiting the VTE Prevention Collaborative Application Website. 
For more information about the VTE Prevention Collaborative program, please contact Taylor Marsh, Project Coordinator, at tmarsh@hospitalmedicine.org or 267-702-2677.

References

1. Goldhaber SZ, Tapson VF. A prospective registry of 5,451 patients with ultrasound-confirmed deep vein thrombosis. Am J Cardiol 2004;93(2):259-62.
2. Task Force on Pulmonary Embolism ESoC. Guidelines on diagnosis and management of acute pulmonary embolism.  [see comments]. European Heart Journal 2000;21(16):1301-1336.
3. Stein PD, Huang H, Afzal A, Noor HA. Incidence of acute pulmonary embolism in a general hospital: Relation to age, sex, and race. Chest 1999;116(4):909-913.
4. Silverstein MD, Heit JA, Mohr DN, Petterson TM, O'Fallon WM, Melton LJr. Trends in the incidence of deep vein thrombosis and pulmonary embolism: A 25-year population-based study. Arch Intern Med 1998;158:585-593.
5. Geerts WH, Pineo GF, Heit JA, Bergqvist D, Lassen MR, Colwell CW, Ray JG. Prevention of venous thromboembolism: The seventh ACCP conference on antithrombotic and thrombolytic therapy. Chest 2004;126(3 Suppl):338S-400S.
6. Stratton MA, Anderson FA, Bussey HI, Caprini J, Comerota A, Haines ST, Hawkins DW, O'Connell MB, Smith RC, Stringer KA. Prevention of venous thromboembolism: Adherence to the 1995 american college of chest physicians consensus guidelines for surgical patients. Arch Intern Med 2000;160(3):334-40.
7. Anderson FA, Jr., Wheeler HB, Goldberg RJ, Hosmer DW, Forcier A, Patwardhan NA. Changing clinical practice. Prospective study of the impact of continuing medical education and quality assurance programs on use of prophylaxis for venous thromboembolism. Arch Intern Med 1994;154(6):669-77.
8. Walker A, Campbell S, Grimshaw J. Implementation of a national guideline on prophylaxis of venous thromboembolism: A survey of acute services in Scotland. Thromboembolism prevention evaluation study group. Health Bull (Edinb) 1999;57(2):141-7.

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This project is supported in part by funding from sanofi-aventis US, LLC

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