Venous thromboembolism (VTE), a condition in which blood clots form (most often) in the deep veins of the leg (known as deep vein thrombosis, DVT) and can travel in the circulation and lodge in the lungs (known as pulmonary embolism, PE), is categorized by the U.S. Surgeon General as a major public health problem. Although relatively common and associated with reduced survival, substantial health-care costs, and frequent reoccurrence, many VTE prevention efforts fail due to lack of standardized guidance integrated at the point of care or due to flawed risk assessment models that either offer no guidance or are so complicated that providers bypass them.
VTE prevention is just one priority among many for busy clinicians and QI leaders, so it is helpful to make hospital leadership aware of how an effective VTE prevention program aligns with its many other goals for medical care, performance reporting, customer service, patient safety, and cost containment. A number of forces may fuel leadership interest in the project, including public reporting of hospital performance (e.g., The Joint Commission [TJC] and National Quality Forum [NQF] measures), Partnership for Patients initiatives, cost savings from more efficient care, risk aversion, favorable payments for better care (e.g., pay for performance), nursing and medical staff retention (e.g., Magnet Recognition Program® ), related projects (e.g., Surgical Care Improvement Project), and even quality for quality’s sake. Furthermore, the Centers for Medicare & Medicaid Services no longer reimburses for the incremental costs of DVT and pulmonary embolism (PE) related to some surgeries (including total knee replacement and total hip replacement), and is considering expanding that list. VTE prevention efforts can also be synergistic with efforts to increase patient activity, reduce central venous catheter complications, and meet meaningful use criteria for electronic health records.Venous Thromboembolism (VTE) Cost Compliance ROI Infographic