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Key Strategies

VTE Prevention: An Institution-wide Initiative University of Michigan Caprini VTE risk assessment May 20, 2012 Marc Moote, PA-C Chief Physician Assistant University of Michigan Health System. Key Strategies. Scope: ALL adult inpatients Standardized VTE Protocol – Caprini model

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Key Strategies

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  1. VTE Prevention: An Institution-wide InitiativeUniversity of Michigan Caprini VTE risk assessmentMay 20, 2012Marc Moote, PA-CChief Physician AssistantUniversity of Michigan Health System

  2. Key Strategies • Scope: ALL adult inpatients • Standardized VTE Protocol – Caprini model • Mandatory risk assessment with CPOE hard-stop • Clinical decision support to drive clinical practice • Required documentation of contraindications with timed reminders to reassess q24 - 48H • Data feedback to services regarding performance • VTE prophylaxis included as peer review (OPPE) indicator for many services • Review of EVERY VTE event that occurs in the health system for preventability

  3. Closing the Gap… • VTE Risk Assessment embedded in all UM-Carelink admission order sets. • VTE risk factor reorganization based on Clinical Advisory Group feedback (by risk factor category rather than by points)- More user friendly • Providers must document clinically appropriate contraindications when deviating from recommendations • Hard stop within UM-Carelink requiring completion of VTE risk assessment prior to admission order submission. • Service specific data to facilitate discussions

  4. Reorganization / grouping of Caprini VTE risk factors make it more user friendly Point total calculated for user, prophylaxis recommendation based on risk score

  5. Order Recommended prophylaxis unless contraindicated VTE Risk Level, contraindications (if present) and ordered prophylaxis capture for analysis

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