Galen ENGINUITY for MEDITECH 6.x/6.1+: Maximize VTE Prophylaxis Compliance скачать в хорошем качестве

Galen ENGINUITY for MEDITECH 6.x/6.1+: Maximize VTE Prophylaxis Compliance

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. An argument to leadership can also be made in terms of VTE incidence and costs. Queries from the University of California system and the University Healthcare Consortium provide estimates that are consistently 1 percent or more of admissions resulting in an HA-VTE. This means that a medical center with 10,000 adult discharges per year could expect to have 100 events of HAVTE, many of them potentially preventable. The rate of hospital-associated VTE likely remains grossly underestimated, however, as reporting does not include patients readmitted to other hospitals, undiagnosed but clinically important VTE, and VTE that is treated in skilled nursing facilities and outpatient environments. Each hospital-associated DVT event represents an incremental cost of $7,700 to $10,800, while each hospital-associated PE event represents $9,500 to $16,600 in additional costs. Acute HAVTE in cancer patients bears an even higher cost, estimated at more than $20,000 per episode.26 As high as this cost is, it does not reflect the longer term costs to society and the patient of recurrent VTE, post-thrombotic syndrome, and pulmonary hypertension. https://www.ahrq.gov/sites/default/fi... Many VTE prevention efforts fail because of a 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. Identifying why past efforts failed to produce desired results will help guide current efforts and avoid repeating the same mistakes.