3Health Committee recommendations 2005 Thrombosis committee should be established in each hospital, with a specialist thrombosis team.Modelled on existing Blood Transfusion teams and committees.A basic standard of expectation should be issued by the DOH pending publication of NICE guidelines.
4Health Committee recommendations 2005 Thrombosis Committee: all interested parties including haematologists, surgeons, physicians, anaesthetists, obstetricians, nursing staff and pharmacists.Ensure clinical governance and provide a local audit of thromboprophylactic procedures in each hospital.
5Health Committee recommendations 2005 A potential draft remit of the Thrombosis Committee:Promote best practice through local protocols based on national guidelines.Lead multi-professional audit of the use of thromboprophylaxis focusing on specialties where risk is high.Promote education and training of all clinical and support staff.Have the authority to modify existing VTE and risk assessment protocols and to introduce appropriate changes to practice.Consult with local patient representative groups where appropriate.Contribute to the development of clinical governance.
6Health Committee recommendations 2005 Thrombosis Teams would:Assist in implementation of Thrombosis Committee’s objectives.Promote and provide advice and support re: appropriate thromboprophylaxis and risk assessment.Actively promote implementation of good thromboprophylaxis practice.Be a source for training all hospital staff involved in dealing with patients at risk of VTE.
7King’s’ experience Anticoagulation/thrombosis committee Established 1999,quarterly meetingsMultidisciplinary group: physicians, surgeons, imaging drs and technicians, nurse specialists, pharmacistsInstrument for clinical governance anddriving change
8Background Adverse incidents related to anticoagulation Awareness of mortality & morbidity due to VTE at King’s‘Ad hoc’ management of clinical thrombosisPractice variations and lack of clear guidelinesManage change - new anticoagulants and treatment strategies
9Setting up a thrombosis committee: Identify stakeholders within TrustMultidisciplinary core group + invite relevant partiesTerms of referenceResource implicationsDecide on agenda: be focused
10Agenda items DVT and PE care pathways New anticoagulant drugs Choice of LMWHThrombolysis for PEThromboprophylaxis for surgical patientsThromboprophylaxis for medical patientsAnticoagulation prescription chartsAudit of anticoagulation & thromboprophylaxisAdverse incidents relating to anticoagulation
11Achievements Establishment of clinical thrombosis services Policies for thromboprophylaxis and treatment of VTEPolicies regarding anticoagulationTrustwide consensus & clinical guidelinesPromote clinical researchResource for education and trainingVital part of the Trust framework for clinical governance & audit