QIPP in practice: VTE prevention

The Clinical Services Journal reports.

Venous thromboembolism (VTE), a condition in which a blood clot forms in a vein, encompasses deep venous thrombosis (DVT) and pulmonary embolism. It arises in primary care as well as in the acute sector and can be a secondary consequence following hospital admission for other medical and surgical problems. Dr Everington started the discussion with the comment that around half of incidents and deaths related to VTE are preventable with the use of readily available thromboprophylaxis methods. Despite widespread knowledge of the value of thromboprophylaxis, the implementation of VTE prevention measures as a measure relevant to all hospital patients has been slow. In 2005, the Chief Medical Officer sent out a call for action and this was shortly followed by the publication of a Health Select Committee report The Prevention of Venous Thromboembolism in Hospitalised Patients. However, it took a few more years for the National Institute for Health and Clinical Excellence (NICE) to produce guidance on the care and treatment of people at risk of developing DVT in hospital, which was finally published in January 2010.1 This guidance states that every patient admitted to hospital – as an inpatient or a day case – should be assessed for risk of VTE and appropriate preventative measures must be taken. “We now have a financial driver for making sure that this actually happens – the CQUIN Payment Framework includes measures on VTE that account for a significant amount of our hospital income,” said Dr Everington.

The Salisbury experience