284 Quality improvement in venous thromboembolism (VTE) risk assessment

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Abstract Aims To improve the rates of venous thromboembolism (VTE) risk assessment on the elective Upper GI surgery ward in a tertiary hospital. Methods A standard of 95% completion of VTE risk assessment within 24 hours of admission was set, in line with our trust policy and NICE guidance. Initial data collection for one month was followed by implementation of measures to improve rates of assessment: raising the issue in our departmental governance meeting, allocation of responsibility to ward based junior doctors for daily checking and completion of assessments and prescriptions, and fortnightly snap audits to check progress. Data was collected from electronic patient records to evaluate the impact of these measures in the subsequent two months. Results Initially, only 75% of VTE assessments were completed. Following the interventions, compliance increased to 89% and subsequently to 98.5%. Conclusion VTE assessment is a mandatory requirement for all admissions with the potential for serious harm if the risk is not assessed and managed appropriately. Compliance was initially poor, falling well below our standard. Following simple interventions and active engagement from junior doctors, this was greatly improved and sustained over two months. Moving forward, we anticipate the main issue to be longevity as junior doctors rotate through the department. We recommend highlighting the issue in departmental induction and allocation of responsibility for ongoing quality improvement to rotating juniors in the role of a ‘VTE champion’. In future work we aim to assess the correlation between improved compliance with risk assessment and incidence of VTE.

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