EDUCATION AS A QUALITY INTERVENTION IN THROMBOPHILIA TESTING

Jessica Zimmerberg-Helms, MS4*;Karissa Vasquez, MS3;Taylor Goot, MD and Patrick Rendon, MD, University of New Mexico School of Medicine, Albuquerque, NM

Meeting: Hospital Medicine 2017, May 1-4, 2017; Las Vegas, Nev.

Abstract number: 226

Categories: Innovations Abstracts, Quality Improvement

Background:

As hospitals continue to see increasing costs, quality improvement interventions are essential to maintaining a high level of quality care in the inpatient setting. Multiple studies have shown that a systems based approach offers a clean and simple method for targeted interventions. However, educational interventions, when maintained over time, have an increased long term affect. Based on international guidelines, testing for thrombophilia is often inappropriate in the inpatient setting, either because a thrombus is provoked, the patient is on an anticoagulant, has an acute thrombus, or because knowledge of a new underlying thrombophilia would not change immediate management. At our hospital, the hypercoagulable panel (HCPAN) is utilized to test for underlying thrombophilia. We aimed to educate residents and hospitalists about thrombophilia testing in the inpatient environment to raise awareness of current international practices.

Purpose:

To enact a sustained improvement in testing practices and provider evaluations of thrombophilia through multiple educational interventions. 

Description:

Through multiple sessions, we educated both residents and hospitalists on the use of thrombophilia testing in the inpatient setting. The result was a decrease in inpatient thrombophilia testing sustained over the two years since starting the educational interventions.

Interventions:

Educational Setting

Date of intervention

Medium of presentation

Best Practices – monthly discussion forum among hospitalist faculty

November, 2013

Oral presentation to 20 UNM hospitalists

NM Regional ACP poster competition

October 2014

Poster presentation to 20 mixed internal medicine residents and hospitalists

Best Practices – monthly discussion forum among hospitalist faculty

March, 2015

Oral presentation to 20 UNM hospitalists

Thursday School Lecture – mandatory lecture to internal medicine residents

July 2015

Oral presentation to 50 UNM residents

NM Regional ACP poster competition

October 2015

Poster presentation to 20 mixed internal medicine residents and hospitalists

NM Regional ACP poster competition

October 2016

Poster presentation to 20 mixed internal medicine residents and hospitalists

Conclusions:

Pre and post analysis of our educational interventions showed a 91% decrease in inpatient panels from before all of the educational interventions. Our results show a substantial and persistent decrease in unnecessary testing over the studied period of our educational interventions.  While systems based interventions are commonly lauded as the standard of quality intervention, our study suggests that educational initiatives still play a role in sustainment of institutional change in the setting of thrombophilia testing. One also wonders if educational interventions gain additional value at academic institutions, as the sheer volume of learners in these centers are likely to spread lessons learned to the medical community.

To cite this abstract:

Zimmerberg-Helms, J; Vasquez, K; Goot, T; Rendon, P . EDUCATION AS A QUALITY INTERVENTION IN THROMBOPHILIA TESTING. Abstract published at Hospital Medicine 2017, May 1-4, 2017; Las Vegas, Nev. Abstract 226. Journal of Hospital Medicine. 2017; 12 (suppl 2). https://www.shmabstracts.com/abstract/education-as-a-quality-intervention-in-thrombophilia-testing/. Accessed September 23, 2019.

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