Venous Thromboembolism Prophylaxis in Surgical Patients:Identifying a Patient Group to Maximize Performance Improvement

摘要

Venous thromboembolism (VTE) in surgical patients is a cause of increased morbidity, mortality, and cost of care. According to a study of more than seven million patients in the United States, postoperative VTE is the second most common medical complication and cause of excess length of stay and the third most common cause of excess mortality and excess charges.1 The excess length of stay from deep vein thrombosis (DVT) or pulmonary embolism (PE) averaged 5.36 days, and the increase in mortality averaged 6.56% (p < .001 for both).1 The National Quality Forum (NQF), which introduced the term never event in 2001 to apply to 27 events,2 later instead referred to (28) serious reportable events (SREs). An SRE had to be of concern to the public and providers, be clearly identifiable and measurable, be usually preventable, and result in death or serious disability.3 In 2007, the Centers for Medicare & Medicaid Services (CMS), in linking payments for health care services to quality, used the NQF list to develop a list of hospital-acquired conditions (HACs)-for which, starting in 2009, hospitals would not be reimbursed additional Medicare payments.4