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Preventing Venous Thromboembolism Participating Hospital Survey

Preventing Venous Thromboembolism Participating Hospital Survey. Why did we do the survey?. Consortium baseline of VTE prophylaxis in medicine patients Data abstraction logistics EMR v. Paper CPOE Ability to Filter Billing Data Access Requirements/Contacts for audit process

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Preventing Venous Thromboembolism Participating Hospital Survey

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  1. Preventing Venous Thromboembolism Participating Hospital Survey

  2. Why did we do the survey? • Consortium baseline of VTE prophylaxis in medicine patients • Data abstraction logistics • EMR v. Paper • CPOE • Ability to Filter • Billing Data Access • Requirements/Contacts for audit process • Request site-specific documents related to VTE risk assessment

  3. Response • Survey distributed to 13 sites on 6/28 • 12 sites responded • 1 site unsure of ongoing participation • 5 additional sites received survey on 7/19 • 2 sites responded • Expect response from 3 remaining

  4. VTE Assessment & Guidelines • 93% “have a specific process for assessing VTE risk, on admission, in medical inpatients” • 93% “have a protocol or guideline for pharmacological VTE prophylaxis” • 77% Generalized to All Patients • 23% Medicine Patients and Surgical Patients • 86% “have a protocol or guideline for mechanical VTE prophylaxis” • 75% Generalized to All Patients • 17% Medicine Patients and Surgical Patients • 8% Medicine Patients • 50% have VTE Committee in place currently

  5. VTE Pharmacological Prophylaxis

  6. Pharmacological Prophylaxis (cont.) Warfarin? • 71% of sites reported warfarin use • Responding for non-medicine patients?

  7. VTE Mechanical Prophylaxis

  8. Electronic v. Paper • 14% all electronic medical record • 21% all paper medical record • 65% mix of both • 36% computerized physician order entry • 64% no CPOE

  9. Selection & Sampling Process • Eligible Cases = Medicine Admissions • Exclusions: • Pregnant • Under age 18 • Admitted for surgery • Admitted for palliative care • Discharged within 24 hours of admission • Admitted to ICU within 24 hours of admission • Admitted for and received treatment for presumed VTE • VTE in 6 months prior to admission • 8-day sampling cycle with 20 eligible cases/cycle • i.e. cycle 1 starts Monday, cycle 2 starts Tuesday, etc.

  10. Filtering Process • 100% ability to electronically filter • Anticipate any problems identifying eligible patients? • 100% capable of doing so in a “timely fashion” • What does timely mean? • How long will the lag be at your site? • Will provide sample filtering process • Based on process will ask sites to indicate lag time

  11. Use of Billing Data • 77% access to billing data for abstractor • 23% no access • Universal Billing Statement (UB-04) • 3 – 30 days to produce • Average = 9.5 days How should billing data be used?

  12. Questions . . . • About Completed Survey? • That should have been asked?

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