Title: Preventing VTE in hospitalised patients Dr Roopen Arya Kings College Hospital
1Preventing VTE in hospitalised patientsDr
Roopen AryaKings College Hospital
2Preventing VTE in hospitalised patients
- Hospitalised patients at high risk of VTE
- VTE leads to substantial cost, mortality and
morbidity - Effective, safe and cost-effective measures to
prevent hospital-acquired VTE exist - Roadmap is in place
- Gap between current practice and optimal practice
remains large - Summary
AHRQ report, 2008
3Thrombosis prevention in the UK
4VTE prevention a global initiative
5Implementing national VTE guidanceprogress
- Implementation Working Group
- Exemplar Centres
- Thrombosis committees local guidelines
- Thrombosis teams
- VTE Risk assessment
6VTE Implementation Working Group
- Established by CMO
- A Thomas (Chair), R Arya, T Baglin, A Flowerdew,
- A Kakkar, E Nicol, T Brown (Coordinator)
- Provide oversight and leadership for
implementation of national VTE strategy in the
NHS and wider healthcare sector - Work closely with stakeholders such as NICE and
HCC to ensure risk assessment of all hospitalised
patients -
-
7VTE Implementation Working Group
- Develop a national VTE risk assessment tool
- Develop Exemplar Centres
- Raising awareness
- Education
8Prevention of VTE in hospitalised patients
V
Documented risk assessment for all hospitalised
patients
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12http//healthguides.mapofmedicine.com/
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14Introduction of computer system
15VTE prevention real-world practice
- ENDORSE survey (2008)
- 52 patients at risk for VTE
- 50 receiving prophylaxis
- (surgical 59 medical 40)
- APPTG survey(APPTG 2nd Annual Audit, 2008)
- 99 acute Trusts were aware of CMOs
recommendations and - NICE guideline
- 70 undertaking documented mandatory risk
assessment - 86 have thrombosis committees
- 87 educate staff re risk of VTE
- VERITY survey
- 94 have thrombosis committees
- gt80 have guidelines for medical and surgical
thromboprophylaxis - lt10 to 95 patients risk assessed for VTE
- 1 in 8 using DH VTE risk assessment
16VTE 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 was first NHS exemplar
centre the London Clinic in the independent
sector - Network of exemplar centres being developed
- 8 exemplar centres at end of 2008
17VTE Exemplar Centres Requirements
- Chief Executive agreement / support
- Mechanism in place for VTE risk assessment
- Audit trail evidence of prevention management
across organisation - Multidisciplinary team approach
- Education and raising awareness re VTE
- Ability to act as a resource to spread good
practice - To apply e-mail roopen.arya_at_kcl.ac.uk
18VTE exemplar centres main elements
- Thrombosis committees
- Thrombosis teams
- Implementation of VTE risk assessment and
thromboprophylaxis - Audit
- Education and awareness
- Clinical research into VTE
19VTE exemplar centres in action
- Models of care
- Excellence at prevention of VTE in hospitalised
patients - Comprehensive care of VTE
- VTE prevention in the community
- Exemplars will include
- NHS Hospital Trusts
- Primary Care Trusts
- Strategic Health Authorities
- Independent sector
20VTE Exemplar Centres
21Exemplar centres education and awareness
- Local activities and training
- E-learning modules
- http//www.elearning-essexrivers.co.uk
- http//doctors.net.uk/education
- e-Learning for Healthcare VTE module in
progress - Lecturing at national courses on
thromboprophylaxis - Hertfordshire Birmingham
- NHS Choices video on DVT http//www.nhs.uk/vide
o
22Exemplar centres education and awareness
- Meetings and workshops
- VTE awareness symposium at the London Clinic
- 26th Sept 2008
- - First national VTE exemplar centre study day
- 18th March 2009 at the Royal Society of Medicine
-
- VTE, a key patient safety issue Patient Safety
Congress 1st May 2009 _at_ the ICC, Birmingham - Workshops for nurses and pharmacists planned
23VTE exemplar centre websitewww.kingsthrombosiscen
tre.org.uk
24Developing a systems-based approach to the
prevention of VTE in hospitalised patients
Patient admitted to hospital
What will success look like?
Professional workforce aware of VTE risk
Individual patient risk assessed for VTE
Appropriate preventative strategy implemented
Evaluation of outcome
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