WSHA Hospital Safety & Quality Priorities: Historical Programs
The WSHA Safety & Quality team is a trusted and collaborative partner supporting Washington hospitals on several key quality and patient safety improvement programs. Historically, WSHA’s initiatives have aligned to support federal programs and support hospitals in achieving national patient safety aims such as:
- Hospital Engagement Network (HEN) and Hospital Improvement Innovation (HIIN)
- The Joint Commission Sentinel Events (CAMLAB_19_SE (jointcommission.org)
- Center for Medicare Services (CMS) Hospital-Acquired Condition Reduction Program | CMS
- National Quality Forum (NQF) endorsed ’27 Serious Reportable Events’ NQF: List of SREs (qualityforum.org)
When a program achieves milestones, objectives and industry standards of care that are widely adopted in our hospitals, our WSHA Board re-evaluates and re-prioritizes these initiatives. If a program has been successful in reducing patient harm, improving, and sustaining clinical quality outcomes in our hospitals, it may be considered ‘historical’ and no longer a key priority topic area.
The Safety & Quality team recognizes that tools, resources, and access to materials for these historical programs and are still valuable to our members.
Venous Thromboembolism (VTE) — a blood clot that starts in a vein — is the most common preventable cause of hospital death. Per the CDC, 10-30% of people die within one month of VTE diagnosis, and sudden death is the first symptom in 25% of people who have a Pulmonary Embolism (PE). VTE is associated with long-term complications, and one-third of patients with a VTE have a recurrence within 10 years. Pharmacological thromboprophylaxis for VTE is safe, effective and cost-effective. However, there is a gap between the evidence and implementation. Thus many hospitalized patients at risk for VTE are not treated with prophylaxis.
Every patient in the hospital setting is at some form of risk for VTE – and that risk needs assessed through a risk assessment protocol, ideally embedded in an electronic medical record, making it easy for physicians to select the appropriate choice of prophylaxis for medical and surgical patients.
Getting Started
The WSHA VTE Safety Action Bundle is a guide to assist facilities in developing a comprehensive multidisciplinary VTE prevention program. WSHA also provides tools for a multi-disciplinary team to use when ready to engage in a test of change for preventing VTEs.
WSHA provides support for hospitals prepared to launch or re-engage in a safe and effective VTE prevention program. We provide on-site assistance, coaching calls, resources, webinars and surgeon-physician consultation. Contact Meg Kilcup for more information and assistance.
VTE Prevention Top-Ten Checklist
Planning an Intervention Job Aid | Venous Thromboembolism
Venous Thromboembolism Prevention | Test of Change Template
Resources
AHRQ’s Preventing Hospital-Associated Venous Thromboembolism
Society of Hospital Medicine: Venous Thromboembolism Implementation Guide
National Institute for Health and Care Excellence: Reducing Venous Thromboembolism Risk in Hospital patients (Interactive Flowchart)
AHRQ Guideline Summary: Best evidence statement (BESt): VTE prophylaxis in children and adolescents
American College of Physicians: Venous Thromboembolism Prophylaxis in Hospitalized Patients (2011)
Measuring Success
AHRQ PSI #12 Specifications Perioperative Pulmonary Empolism