Each year, there are more than 30 million surgeries
performed in the U.S., and venous thromboembolisms (blood clots) are one of the
most common postoperative complications. While postsurgical venous
thromboembolisms (VTE) are considered a hospital acquired condition, most can
be prevented by following a few evidence-based guidelines.
In alignment with the recommended strategies to prevent VTE,
staff at Lakeview Hospital in Stillwater regularly ordered postoperative
mechanical and pharmacological treatments for surgical patients, but the
approaches were inconsistent across hospital units. With the mantra to do
“what’s best for the patient,” Lakeview Hospital staff set out to standardize
its approach to VTE prevention.
To successfully tackle the change, Lakeview focused on three
areas: hospital culture, leadership and standardization. Change can be a
difficult pill to swallow and quality improvement leaders knew it would be
critical to get buy-in from physician leaders and hospital administration. By
reviewing literature and implementing best practices through teamwork and
collaboration, Lakeview was able to update approximately 20 pre-printed order
sets to reflect CMS guidelines and ensure a standardized approach to provide
patients with safe, effective and timely patient-centered care.
After a thorough needs analysis from the different units and
a review of the literature for the effectiveness of the different mechanical
devices available to prevent VTE, a standard device was selected to use across
units. The new mechanical devices are quieter and easier to put on, improving
both patient and nurse satisfaction. Lakeview’s patient satisfaction scores
consistently average in the 95th percentile. Furthermore, after
implementation of the change, the hospital has achieved 100 percent compliance
with national quality standards. And the icing on the cake: in 2011, Lakeview
realized savings of $45,000 by standardizing mechanical devices.
“It took collaboration and for everyone to be involved for
this project to be successful,” said Cindy Appleseth, RPh, director of pharmacy.
“And our patients are the ultimate winners!”