VTE PREVENTION UPDATE, WA (May 2010).ppt

VTE PREVENTION UPDATE, WA (May 2010) Safety and Quality Investment for Reform (SQuIRe) Program Since 2006/07 $8M each year across WA Health 8 quasi-collaboratives addressing priority clinical practice improvement areas IHI “bundles”, process improvement focus Central OSQ department “scaffolding” Not voluntary Area Health Services (x4) determine resource allocation and implementation SQuIRe VTE prevention AIM prevent VTE by performing risk assessment and correct prophylaxis (based on VTE Working Gp evidence summary – NB no formal state policy) PROCESSES TO MEASURE AND IMPROVE % patients risk assessment % patients at risk receiving correct prophylaxis Aligned with QUM indicator defn and sampling method Suggested initial focus surgical patients Mid 2009 progress 2010 aim – generate a “sense of urgency” Visit by NHS experts February 2010 Created WA VTE Prevention Network - 3 meetings, evolving interprofessional community of practice “bring outside in” (Kotter) Share ideas, experiences, learnings Generate stories and new ideas Generate data and talk about it in a meaningful way Ideas progressing / testing NIMC risk assessment and mechanical prophylaxis prescription incorporation “signal” event investigation State VTE prevention policy State risk assessment tool Craft group – specific prophylaxis guidelines ?via Clinical Networks / professional Investigating value of coded data Talking to RFDS for country patient transfer diagnoses Estimating Iatrogenic VTE Burden WA UK 12 000 000 adult admissions; 311 000 inpatient VTE in untreated pts; 124 400 deaths/yr in untreated pts (UK Parliamentary Report) WA 400 000 adult admissions; 10 366 inpatient VTE in untreated pts; 4 146 deaths/yr in untreated pts Est. 25 VTE untreated pts / 1000 separations Iatrogenic VTE Incidence - Literature Gallagher et al (2009): 2.57 cases / 1000 CWS /content/18/5/408.full Leibson et al (2008): 2.59 / 1000 ‘encounters’ /lww-medicalcare/Abstract/2008/02000/Identifying_In_Hospital_