Venous thromboembolism (VTE) prophylaxis for surgical patients
cannot be overemphasized. The Joint Commission, the American College
of Surgeons, the American College of Chest Physicians, the Agency
for Healthcare Research and Quality, and others advocate risk-appropriate
prophylaxis for all surgical patients. Despite strong evidence supporting
its efficacy, VTE prophylaxis is frequently underutilized, with reported
rates of 32% to 59%.1,2 Although VTE has been labeled a “never event” by some
organizations, it is clear that many hospital-acquired events are
not preventable.3,4 A
newly suggested definition of preventable harm linking the process
of VTE prophylaxis to outcomes3 has
been adopted as a Clinical Quality Measure by the Centers for Medicare
and Medicaid Services in their “meaningful use” incentive
program. We sought to link process and outcome data from disparate
sources in order to determine the proportions of surgical patients
prescribed risk-appropriate VTE prophylaxis who developed potentially
Figure. The percentage of patients
with postoperative venous thromboembolism (VTE), deep vein thrombosis
(DVT), and pulmonary embolism (PE) who were prescribed risk-appropriate
VTE prophylaxis compared with those who were not. The vast majority
of VTE events occurred in patients prescribed risk-appropriate prophylaxis.
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