Preventability of Hospital-Acquired Venous Thromboembolism | Health Care Safety | JAMA Surgery | JAMA Network
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Research Letter
September 2015

Preventability of Hospital-Acquired Venous Thromboembolism

Author Affiliations
  • 1Division of Acute Care Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
  • 2Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
  • 3Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
  • 4Department of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland
  • 5Armstrong Institute for Patient Safety, Johns Hopkins Medicine, Baltimore, Maryland
  • 6Division of Health Sciences Informatics, Johns Hopkins University School of Medicine, Baltimore, Maryland
  • 7Department of Pharmacy, Johns Hopkins Hospital, Baltimore, Maryland
  • 8Division of Hematology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
  • 9Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
JAMA Surg. 2015;150(9):912-915. doi:10.1001/jamasurg.2015.1340

Venous thromboembolism (VTE) is a common, largely preventable condition. The Agency for Healthcare Research and Quality reports that VTE prophylaxis is among the top-10 strongly suggested practices for improving patient safety.1 Although optimal VTE prevention requires both prescription and administration of prophylactic medications, to date, most attempts to improve care have focused predominantly on medication prescription.2

National bodies (eg, the Centers for Medicare and Medicaid Services) and regional entities (eg, the Maryland Health Services Cost Review Commission) impose financial penalties for hospitalized patients developing VTE despite evidence that not all events are preventable, even with prophylaxis.3 Publicly reported measures from both The Joint Commission’s Core Measures and the Centers for Medicare and Medicaid Services’ Hospital Compare report whether a patient received at least 1 dose of VTE prophylaxis within the first day of hospitalization, rather than considering all prescribed and administered doses for the entire hospitalization.4

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