Automated Real‐Time Relay of Actionable Performance Data to a Medical Nursing Unit Improves Venous Thromboembolism Prophylaxis Rates

1Emory University School of Medicine, Atlanta, GA
2Emory University School of Medicine, Atlanta, GA
3Emory University School of Medicine, Atlanta, GA
4Emory University School of Medicine, Atlanta, GA

Meeting: Hospital Medicine 2009, May 14-17, Chicago, Ill.

Abstract number: 96

Background:

Performance data in hospitals is typically derived from retrospective sampling, significantly restricting its relevance for active inpatients. If performance data could be relayed electronically in real‐time to the nursing unit, members of the frontline clinical team could actively use the information to rapidly identify and correct missed opportunities in quality of care for individual patients. We tested this hypothesis for venous thromboembolism (VTE) prophylaxis on a medical nursing unit in our academic teaching hospital.

Methods:

In a before‐after time series, we introduced a solitary intervention to medical nursing units. The intervention consisted of an automated, real‐time relay of the VTE prophylaxis order status of all patients on the nursing unit. The daily and overall prevalence and type of VTE prophylaxis for the nursing unit were calculated before and after the intervention. Prior to the current intervention, active efforts in VTE prophylaxis at our hospital included VTE prevention as a major organizational priority, a specific goal of achieving prophylaxis rates above 90% on medical nursing units, and a standardized VTE risk assessment protocol integrated in paper‐based medical admission order sets.

Results:

Compared with the 35‐day period prior to the intervention, the mean prevalence of any VTE prophylaxis during the 15‐day period following the intervention increased from 84.9% to 93.6% (P < 0.0001) on the medical nursing unit (Figure 1). The main increase in VTE prophylaxis orders was a result of phar‐macologic prophylaxis (70.3% before, 76.7% after, P = 0.03). Mechanical prophylaxis rates did not change as a result of the intervention (14.6% before, 16.8% after, P = 0.44).

Figure 1. In this before–after time series, the early effect on an intervention consisting of real‐time relay of actionable performance data to the medical nursing unit is graphically depicted. Compared with the 35 days prior to the intervention, a statistically significant increase in the prevalence of orders for VTE prophylaxis occurred in the 15 days after introducing the intervention. No statistically significant increase was observed in the prevalence of mechanical prophylaxis only.

Conclusions:

These preliminary results suggest that automated, real‐time relay of actionable performance data to nursing units may represent a durable tool to increase the prevalence of orders for VTE DroDhvlaxis on an inpatient nursing unit. However, more research is needed to determine sustainability and transferability of the strategy, its ability to facilitate increased appropriate pharmacologic VTE prophylaxis, and the effect on clinical, service, and cost outcomes.

Author Disclosure:

J. Stein, Emory Healthcare and Emory University, employer; Ingenious Med, Inc., stock holdings; sanofi, honoraria; Society of Hospital Medicine, independent contractor; S. Chemetsky Tejedor, Emory Healthcare and Emory University, employer; HShabbir, Emory Healthcare and Emory University, employer; D. Dressier, Emory Healthcare and Emory University, employer.

To cite this abstract:

Stein J, Tejedor S, Shabbir H, Dressier D. Automated Real‐Time Relay of Actionable Performance Data to a Medical Nursing Unit Improves Venous Thromboembolism Prophylaxis Rates. Abstract published at Hospital Medicine 2009, May 14-17, Chicago, Ill. Abstract 96. Journal of Hospital Medicine. 2009; 4 (suppl 1). https://www.shmabstracts.com/abstract/automated-realtime-relay-of-actionable-performance-data-to-a-medical-nursing-unit-improves-venous-thromboembolism-prophylaxis-rates/. Accessed May 26, 2019.

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