Recorded presentation

Jean Fleischman, MD¹, Gordon Lutchman, MD², Consuelo Dungca, RN, EdD³, Juliet Gaengan, RN, MPA³, and Karen Scott Collins, MD, MPH⁴. (1) Department of Medicine, Queens Hospital Center, 82-68 164th St., N Building 7th Floor, Jamaica, NY 11432, 718-883-4050, fleischj@nychhc.org, (2) Department of Surgery, Coney Island Hospital, 2601 Ocean Parkway, Brooklyn, NY 11235, (3) Office of Clinical Affairs, Central Office, NYC Health and Hospitals Corporation, 125 Worth St Suite 427, New York, NY 10013, (4) Health Care Quality and Clinical Services, New York City Health and Hospitals Corporation, 346 Broadway Suite 1111, New York, NY 10013

Prevention of deep vein thrombosis (DVT) is essential because it may lead to life threatening pulmonary embolism (PE) as well as long term complications including the post-phlebitic syndrome. Despite availability of proven preventative modalities, universal implementation of these measures has not been achieved. Improved utilization of preventative measures and increased recognition of thomboembolic complications, is essential as the incidence of this complication is likely to rise due to increasing patient age and chronicity of comorbid diseases which predispose to thrombosis. The NYC Health and Hospitals Corporation (NYCHHC) is comprised of 11 public hospitals in NYC. The corporation’s Quality Assurance Committee recognized that DVT/PE is a common but avoidable complication of hospitalization and that effective preventative measures can contribute to improved morbidity and mortality. A system wide multidisciplinary task force was convened to develop and implement evidence based standardized strategies to increase provider knowledge regarding prevention, diagnosis and treatment of thromboembolic disease. In addition, a patient education program was created to increase patient awareness of risk factors and presenting symptoms of DVT. The program was designed to be applicable to multiple facilities serving a diverse patient population within the NYCHHC. The multifaceted program included: 1) A review of the mandatory New York State Patient Occurrence Reporting and Tracking system data regarding DVT/PE throughout HHC’s 11 acute care facilities which highlighted variation in occurrence rates across the hospitals, among different departments within the institutions and between various disease entities. 2) Standardized provider education materials: A didactic program was created and distributed to each facility with an educator designated to provide mandatory training at the local level with progress reports sent to the task force. 3) Risk assessment and recommended treatment plan: An evidence based instrument was developed to assess thromboembolic risk, along with treatment guidelines, which will be administered to all inpatients. 4) Patient education: A patient oriented brochure was developed increasing awareness of DVT, its associated risk factors and symptoms. 5) Data analysis: A registry of patients developing DVT will be created to assess risk factors and efficacy of educational and prophylactic modalities among the broad categories of disease represented in our inner city patient population. 6) Outcome and Quality assessment: The rate of DVT and PE will be tracked at each facility before and after program implementation along with adherence to recommendations. These measures are anticipated to reduce the health threat of thromboembolic disease.

Learning Objectives:

• To raise awareness and enhance management of thromboembolic disease prevention among providers and patients.
• To be able to implement best practices in preventing DVT/PE in hospitalized patients.

Keywords: Health Care Quality, Disease Prevention

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Recorded presentation