VTE Prophylaxis Initiative
A Quality Improvement Priority
Venous thromboembolisms (VTEs)—including postoperative deep vein thrombosis (DVT) and pulmonary embolism (PE) following total hip replacement (THR) and total knee replacement (TKR) surgery—are now designated as hospital-acquired conditions (HACs) by the Centers for Medicare & Medicaid Services (CMS).27 HACs are conditions that are not present upon admission, but that are subsequently acquired during hospital stay and could reasonably have been prevented through adherence to evidence-based guidelines. CMS will no longer pay for HACs and, by withholding payment, are encouraging hospitals to prevent an adverse event and improve the reliability of care.
Why is VTE a focus for quality initiatives?
VTE is associated with a significant burden to society:
- Between 200,000 and 300,000 US patients die of VTE each year (surgery-related and non–surgery-related)—more deaths than from AIDS, breast cancer, and traffic accidents combined28,29
- VTE causes an approximate 10% hospital readmission rate by day 90 post surgery* and results in substantial resource utilization and excess charges30
According to the National Quality Forum, which developed the National Voluntary Consensus Standards for Prevention and Care of Venous Thromboembolism with the Joint Commission:
- VTE is the most common preventable cause of hospital deaths in the United States31
- Patients with risk factors can be identified31
- Effective strategies are available to prevent DVT and PE31
Hip Replacement SurgeryFACT:
The Agency for Healthcare Research and Quality has reported that thromboprophylaxis was the number-one patient safety practice prioritized among nearly 70 practices reviewed29
Click to find out more about Surgical Care Improvement Project, Physician Quality Reporting Initiative, or Quality Improvement Organizations
*Results from a study using a large integrated US health care claims database of patients undergoing THR, major knee surgery, or hip fracture repair (N=11,960) between January 1993 and December 1998. Patients were followed for 90 days post surgery.30
