Increased national awareness about potentially tragic patient outcomes from venous thromboembolism (VTE) and an internal review of inpatient thromboembolic events prompted health care providers at Rex Healthcare to begin a 5-year initiative called “Stop the Traveling Clot.”
In 2004 a multidisciplinary team at Rex Healthcare began an initiative to decrease the incidence of VTE in its hospital patients. “Stop the Traveling Clot” educated all health care providers and developed a unique VTE assessment tool. The tool included a risk scoring system and recommendations for preventing VTEs. The initial program targeted a high-risk population of critically ill and post-operative patients, and results were encouraging. A series of annual educational events and six continuous improvement (Plan-Do-Check-Act or PDCA) cycles, helped refine the process and the electronic assessment tool. The tool has been embraced by the medical staff; it is used with 100 percent of all hospital admissions and repeated every 72 hours or if there is any change in level of care. The assessments are easily accessible to all providers via the electronic medical record (EMR).
“Stop the Traveling Clot” changed practice to include routine VTE risk assessment on all inpatients at admission and continuously throughout the hospital stay, increased the use of mechanical (53 percent) and pharmacologic measures (43 percent) to prevent VTE and decreased the number of patients readmitted to the hospital within 30 days with a primary diagnosis code of a thromboembolic event by 12.58 percent. Pharmacologic prophylaxis is started within 24 hours of an assessment for 100 percent of at-risk medical inpatients and 97.6 percent in at-risk surgical patients.
This dramatic increase in assessment and prevention of VTE resulted in improved prophylaxis and a demonstrated reduction of morbidity for hospitalized patients.
Multidisciplinary Team
Jane Hughes, B.S. Pharm., M.B.A.
Roger Adkins, B.S.N.
Dawn Beach, Pharm.D.
Timothy Carter, M.D.
Ruth Ann Go, R.N.
Daniel Licatese, B.S.N.
Kathrine McKenna, (DEGREE)
Robert Mitchell, B.S. Pharm.
Allyson Perry, B.S.N.
Ginger Phelps, B.S.N.
Mary Lou Powell, M.S.N.
Liane E. Salmon, B.S.N.
Wayne Smith, M.D.
Susan Sherman, Ph.D.
Daniel Vig, M.D.
Sherry Whitt, R.N.
Christine Zone, Pharm.D.