Surgical Care Improvement Project Prevention of Post-operative Venous Thromboembolism Team Membership Department of Surgery, Nursing, General Medicine, Pharmacy, CCE

Opportunity Statement Venous thromboembolism (VTE- deep vein thrombosis and pulmonary embolism) is the most common preventable cause of death following surgery. The rate of post-operative VTE at LUMC (2-3%) is at the 90 th percentile compared to other Academic Medical Centers (UHC data)

Project Goals Achieve a 50% reduction in the occurrence rate of post-operative venous thromboembolism

Most Likely Causes for Current Opportunity Surgical patients are not routinely assessed and stratified for VTE risk Wide variability in use of prophylactic methods Variable awareness of national, evidence-based guidelines* Under utilization of pharmacologic prophylaxis (heparin) * Geerts, WH et al. Prevention of venous thromboembolism: The Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest 2004;126:338s-400s.

Solutions Implemented Developed and piloted Risk Assessment Tool in the Department of Surgery Developed guideline for selection of appropriate VTE prophylaxis for surgical patients Revised current standing post-operative orders in the Department of Surgery, Orthopaedics and Neurosurgery to include heparin or enoxaparin.

Next Steps Ongoing monitoring of risk assessment tool use Continued education of physicians and nursing staff Continue comparison with UHC data