Maria Bautista1, Adolfo Llinás2, Guillermo Bonilla3, Klaus Mieth3, Mario Diaz3, Fernanda Rodriguez1. 1. Department of Orthopedics and Traumatology, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia. 2. Department of Orthopedics and Traumatology, Hospital Universitario Fundación Santa Fe de Bogotá, School of Medicine, Universidad de Los Andes, School of Medicine, Universidad del Rosario, Bogotá, Colombia. Electronic address: adolfo.llinas@fsfb.org.co. 3. Department of Orthopedics and Traumatology, Hospital Universitario Fundación Santa Fe de Bogotá, School of Medicine, Universidad de Los Andes, School of Medicine, Universidad del Rosario, Bogotá, Colombia.
Abstract
INTRODUCTION: Identifying risk factors and strategies for the prevention of deep venous thromboembolism in major orthopedic surgery has allowed the development of Clinical Practice Guidelines (CPGs). Currently, there is a gap between clinical practice and the implementation of the recommendations of CPGs. The purpose of this paper is to report the impact of the implementation of improvement strategies on adherence to venous thromboembolism (VTE) prophylaxis guidelines. MATERIALS AND METHODS: We defined 3 quality indicators to assess the adequate use of thromboprophylaxis according to CPGs. We obtained a baseline measurement and identified several barriers for adherence. Six improvement strategies to promote adherence to CPGs were designed and applied. A systematic monitoring of these indicators was performed in real time and a description of the data was completed for patients undergoing primary joint replacement of the hip, knee and shoulder, during February 2012 and August 2014. RESULTS: Data from 773 patients were obtained. In the first trimester, the average of adherence was: 98.3% for medical order in the post-operative note, 60.3% for opportune administration and 67% for adherence to therapy at home. In the trimester, the rates of adherence were 100%, 95.7% and 100% respectively. CONCLUSIONS: Combined strategies for improvement of adherence to VTE prophylaxis is associated with higher compliance with clinical practice guidelines.
INTRODUCTION: Identifying risk factors and strategies for the prevention of deep venous thromboembolism in major orthopedic surgery has allowed the development of Clinical Practice Guidelines (CPGs). Currently, there is a gap between clinical practice and the implementation of the recommendations of CPGs. The purpose of this paper is to report the impact of the implementation of improvement strategies on adherence to venous thromboembolism (VTE) prophylaxis guidelines. MATERIALS AND METHODS: We defined 3 quality indicators to assess the adequate use of thromboprophylaxis according to CPGs. We obtained a baseline measurement and identified several barriers for adherence. Six improvement strategies to promote adherence to CPGs were designed and applied. A systematic monitoring of these indicators was performed in real time and a description of the data was completed for patients undergoing primary joint replacement of the hip, knee and shoulder, during February 2012 and August 2014. RESULTS: Data from 773 patients were obtained. In the first trimester, the average of adherence was: 98.3% for medical order in the post-operative note, 60.3% for opportune administration and 67% for adherence to therapy at home. In the trimester, the rates of adherence were 100%, 95.7% and 100% respectively. CONCLUSIONS: Combined strategies for improvement of adherence to VTE prophylaxis is associated with higher compliance with clinical practice guidelines.
Authors: Austin V Stone; Avinesh Agarwalla; Anirudh K Gowd; Cale A Jacobs; Jeffrey A Macalena; Bryson P Lesniak; Nikhil N Verma; Anthony A Romeo; Brian Forsythe Journal: Orthop J Sports Med Date: 2019-01-28
Authors: Helen Mary Badge; Tim Churches; Justine M Naylor; Wei Xuan; Elizabeth Armstrong; Leeanne Gray; John Fletcher; Iain Gosbell; Christine Lin; Ian A Harris Journal: PLoS One Date: 2021-11-18 Impact factor: 3.240