Mark De Anda, UC Davis
Results of a UC-wide venous thromboembolism (VTE) prevention program, led by Gregory Maynard, chief quality officer for UC Davis Medical Center, have shown a significant reduction in hospital-associated VTEs at all five participating UC hospitals, according to a recently released study authored by Maynard and published in the December issue of the Journal of Hospital Medicine.
Results from the collaborative UC project showed a 24 percent decrease in the occurrence of VTE in adult medical and surgical patients at UC hospitals between 2011 and 2014.
Venous thromboembolism is the collective term for blood clots that form in the deep veins of the leg or pelvis (also known as deep vein thrombosis) and for a pulmonary embolism, which occurs when deep vein clots dislodge and travel to the lung.
UCs VTE prevention program was one of eight projects selected in March to participate in the Centers for Disease Control Healthcare-Associated VTE Prevention Challenge.
The 24 percent VTE reduction surpassed the project’s target goal of 20 percent. Interventions introduced during the three-year project, which was funded by a grant from the University of California’s Center for Health Quality and Innovation, prevented about 170 VTE cases and saved approximately $2 million annually.
Maynard, who also is a clinical professor of medicine at UC Davis, cited a number of reasons for the success of the project.
“Good metrics for process and outcomes, leadership and proven strategies to introduce VTE risk assessments into order sets were all part of the picture,” said Maynard.
“We saw a big decrease in VTE rates at our own hospital by incorporating innovative, real-time monitoring techniques and getting outstanding support from pharmacy and nursing champions,” added Maynard, who credited UC Davis colleague Richard White, chief of general medicine, as well as support from the Gordon and Betty Moore Foundation, for helping achieve the project’s goals. “Plus, those impressive VTE-reduction results were achieved by all the other UC medical centers as well.”
The UC team developed and implemented a collaborative infrastructure, an easy-to-follow protocol and a proven quality-improvement framework. The strategies, measures and interventions used for the project are available in a VTE prevention toolkit, which was authored by Maynard and is now available from the Agency for Healthcare Research and Quality.
Other leaders on the project were Richard White of UC Davis, Alpesh Amin of UC Irvine, Nasim Afsarmanesh of UCLA, Ian Jenkins of UC San Diego, and Andrew Auerbach and Raman Khanna of UC San Francisco.