Communitywide program cuts DVT complications

Review of outcomes data prompted joint effort

A review of outcomes data at St. Luke’s Rehabilitation Institute in Spokane, WA, prompted communitywide standards for prevention of deep venous thrombosis (DVT) or pulmonary emboli problems (PE).

A chart review at St. Luke’s showed that 7% of patients were transferred to acute care hospitals for medical complications during their rehabilitation stay, and the majority of these complications were related to DVT or PE.

The staff took their findings to a citywide task force on pharmacy and therapeutics that was developed by the medical community to standardize medication use for patient care in the prevention of DVT/PE.

The task force recommended routine assessment of patients for DVT/PE risk and treatment protocols for prevention of DVT/PE in patients.

As a result, the number of patients transferred from rehab to acute care for DVT/PE has dramatically decreased, says Nancy Hughes, director of St. Luke’s inpatient and day rehab programs.

"At the time, treatment protocols and care management of patients with DVT and PE were not standardized in our community, and the numbers we were seeing were a concern to us," Hughes says.

"We pointed out that this was something that was happening, and we looked at ways to improve it so we won’t have the higher costs associated with interrupting rehab and returning patients to the acute care hospital," Hughes says.

Stroke patients with a paralyzed lower extremity due to hemiplegia were identified as a high risk for DVT. This patient group is now routinely assessed for DVT/PE risk, and prophylaxis is prescribed.

The task force is now conducting a study that compares the use of medications and other treatments to prevent DVT/PE in spinal cord injury patients, Hughes says. The study also will compare the costs vs. outcomes to help in developing protocols for DVT prevention in spinal cord patients, she says.

The overall goal of the task force is to improve outcomes and overcome DVT/PE through an interdisciplinary continuum-wide plan, she says.