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The role of VTE exemplar centres: the Kings College Hospital experience

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Resource for demonstration of best practice ... Minimise delays & reduce hospital admissions. Provide a cost-effective service ... Reduced admissions, bed days saved ... – PowerPoint PPT presentation

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Title: The role of VTE exemplar centres: the Kings College Hospital experience


1
The role of VTE exemplar centresthe Kings
College Hospital experience
  • Dr Roopen Arya
  • Kings College Hospital NHS Foundation Trust
  • 2008

2
VTE Exemplar Centres
  • Resource for demonstration of best practice
  • Based within hospitals or networks with an
    existing track record of excellent VTE management
  • Expanded role including quality control, audit
    and education
  • Help develop national risk assessment strategy,
    audit tools, centralised educational material to
    support local programmes
  • Kings College Hospital is first NHS exemplar
    centre the London Clinic in the independent
    sector
  • Plan to develop network of exemplar centres

3
VTE Exemplar Centres
  • Chief Executive agreement / support
  • Mechanism in place for VTE risk assessment
  • Audit trail evidence of prevention management
    across organisation
  • Education and raising awareness re VTE
  • Multidisciplinary team approach
  • Ability to act as a resource to spread good
    practice

4
Thrombosis committee
  • Anticoagulation / thrombosis
  • committee
  • Established 1999,
  • quarterly meetings
  • Multidisciplinary group
  • Instrument for clinical governance enabling
    change

5
Agenda items
  • Setting up a thrombosis team
  • DVT and PE care pathways
  • Anticoagulant drugs
  • Thromboprophylaxis for surgical patients
  • Thromboprophylaxis for medical patients
  • Audit
  • Adverse incidents

6
Achievements
  • Establishment of clinical thrombosis services
  • Policies for thromboprophylaxis and treatment of
    VTE
  • Policies regarding anticoagulation
  • Trustwide consensus clinical guidelines
  • Promote clinical research
  • Resource for education and training
  • Vital part of the Trust framework for clinical
    governance audit

7
Kings Clinical Thrombosis Service
  • Dedicated multidisciplinary service
  • Best practice / evidence-based treatment
  • Minimise delays reduce hospital admissions
  • Provide a cost-effective service
  • Improve quality of care

8
Integrated Care Pathway for DVT
9
Kings Clinical Thrombosis Service
  • Cared for gt4000 patients with suspected DVT
  • age range 16 yrs to 101 yrs
  • 25 treated for DVT, 90 treated at home
  • Outpatient management safe effective
  • Improved care flexible patient-focused service

10
Kings Clinical Thrombosis Service
  • Reduced admissions, bed days saved
  • Close links with Primary Care 73 patients
    direct referrals from GPs reduced presentations
    to A E
  • Short waiting times diagnosis within 2 hrs,
    treated within 4 hrs
  • Patient satisfaction empowerment
  • Lessons from DVT care applied to care of patients
    with pulmonary embolism

11
Seamless care
A E
Wards
Primary Care
DVT CLINIC
Promoting VTE prevention
ANTICOAGULATION CLINIC
THROMBOPHILIA CLINIC
12
Education
  • Senior and junior doctors
  • Nurses
  • Pharmacists
  • Trust Management
  • Trust risk management other committees
  • Patients

13
Clinical audit
  • Risk assessment
  • Uptake medical thromboprophylaxis
  • Uptake surgical thromboprophylaxis
  • Compliance with local guidelines appropriate
    thromboprophylaxis
  • Counselling of patients re risk
  • Outcome measures
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