A project at all five University of California medical centers, led by Gregory Maynard, Chief Quality Officer for UC Davis Medical Center, is a winner of the 2015 CDC Healthcare-Associated Venous Thromboembolism (HA-VTE) Prevention Challenge.
Among the many submissions received by the CDC, the UC project was one of eight announced today as 2015 HA-VTE Prevention Challenge Champions. The CDC launched the challenge to recognize and reward hospitals and health systems that have shown leadership and dedication to protecting patients from developing VTE by implementing innovative and effective prevention strategies.
The UC project was named as a champion in the category of "Large Healthcare Network or Multi-Hospital System." Also selected in that category was the Mayo Clinic of Rochester, Minn.
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, or DVT) and for pulmonary embolism (PE), which occurs when deep vein clots dislodge and travel to the lung. Blood clots are a leading cause of preventable deaths in hospitals nationwide.
At UC’s five medical centers (UCLA, UC Irvine, UC Davis, UC San Diego and UC San Francisco), preliminary data from 2010-11 showed that almost 700 patients (almost 1 percent) per year suffered from hospital-associated venous thromboembolism. Barriers to providing optimal prophylaxis included:
- Absence of a standardized approach to VTE risk assessment
- Lack of consensus on appropriate prophylaxis options for various inpatient populations
- Electronic health records (EHRs) from more than one vendor, with decentralized control
- A relative lack of collaborative infrastructure
The UC team developed and implemented a collaborative infrastructure, an easy-to-follow protocol and a proven quality-improvement framework. Through these measures, the project reduced the VTE rate at UC medical centers by 24 percent from 2011-14, preventing about 170 VTE cases and saving $2 million a year.
In July 2011, the UC Center for Health Quality and Innovation awarded a $750,000 grant to a team of UC faculty members to create a systemwide effort to reduce UC’s already low VTE rate by at least 20 percent through focusing on preventive measures in adult medical-surgical hospital patients. At the time of the grant award, Maynard, the project’s principle investigator, was a clinical professor of medicine in the Division of Hospital Medicine at UC San Diego. He joined UC Davis Medical Center in 2015.
Other leaders on the project were Richard H. White of UC Davis, Alpesh N. Amin of UC Irvine, Nasim Afsarmanesh of UCLA, Ian H. Jenkins of UC San Diego, and Andrew Auerbach and Raman Khanna of UC San Francisco.
The strategies, measures and interventions used for this collaborative project are available in a VTE prevention toolkit authored by Maynard and available from the Agency for Healthcare Research and Quality.