Department of Research, Division of Healthcare Quality Evaluation and Improvement, The Joint Commission, Oakbrook Terrace, Illinois, USA.
Department of Quality Measurement, Division of Healthcare Quality Evaluation and Improvement, The Joint Commission, Oakbrook Terrace, Illinois, USA.
J Hosp Med. 2024 Sep;19(9):827-840. doi: 10.1002/jhm.13385. Epub 2024 May 21.
Venous thromboembolism (VTE), including deep vein thrombosis and pulmonary embolism, is a life-threatening, costly, and common preventable complication associated with hospitalization. Although VTE prevention strategies such as risk assessment and prophylaxis are available, they are not applied uniformly or systematically across US hospitals and healthcare systems. Hospital-level performance measurement has been used nationally to promote standardized approaches for VTE prevention and incentivize the adoption of guideline-based care management. Though most measures reflect care processes rather than outcomes, certain domains including diagnosis, treatment, and continuity of care remain unmeasured. In this article, we describe the development of VTE prevention measures from various stakeholders, measure strengths and limitations, publicly reported rates, the impact of technology and health policy on measure use, and perspectives on future options for surveillance and performance monitoring.
静脉血栓栓塞症(VTE),包括深静脉血栓形成和肺栓塞,是一种危及生命、代价高昂且常见的可预防的住院相关并发症。尽管存在诸如风险评估和预防等 VTE 预防策略,但在美国的医院和医疗体系中,这些策略并未得到统一或系统地应用。医院层面的绩效衡量已在全国范围内用于促进 VTE 预防的标准化方法,并激励采用基于指南的护理管理。尽管大多数措施反映的是护理过程而不是结果,但某些领域,包括诊断、治疗和护理连续性,仍未得到衡量。在本文中,我们描述了来自不同利益相关者的 VTE 预防措施的制定,衡量了这些措施的优缺点、公开报告的比率、技术和医疗政策对措施使用的影响,以及对未来监测和绩效监控的选择方案的看法。