Coagulation

Haematologists must be champions of VTE prevention teams


A/Pro Huyen Tran

Haematologists have been urged to take the lead in implementing Australia’s first national Venous Thromboembolism Prevention Clinical Care Standard.

Speaking at the launch of the standard, Victorian haematologist Associate Professor Huyen Tran said its goal was to ensure that all patients in hospitals are assessed for VTE risk and given a VTE prevention plan if necessary.

The new standard, developed by the Australian Commission on Safety and Quality in Health Care (ACSQHC), could help avoid many of the 5,000 fatalities from hospital-acquired VTE in Australia each year, said Professor Tran, who is Head of the Haemostasis and Thrombosis service at The Alfred hospital, Melbourne.

The standards were developed after it was noted that VTE accounted for around 10% of all hospital deaths in Australia and yet fewer than half of hospital clinical units were routinely assessing patients for VTE risk.

Haematologists were a key part of the group developing the standard and should also play key role in ensuring ‘buy-in’ from the clinician groups such as surgeons who manage patients at high risk of VTE, Professor Tran told the limbic.

“This is a really important public health issue where haematologists should take a lead,” he said.

“We can reduce the incidence of VTE by up to 70% with VTE prevention teams within hospitals and haematologists need to champion this – these teams could be led by haematologists,” he said.

Professor Tran gave the example of his own hospital, where a multidisciplinary team developed and implemented VTE prevention policies that resulted in 80% of eligible patients receiving appropriate VTE prophylaxis.

But he said it was important to have involvement from all departments rather than a top-down, one-size-fits-all guideline for a hospital, he stressed.

“For example the surgeons doing hip and knee replacements are admitting and providing care for patients who are at risk of VTE, so it’s important to engage with these units and  get their input,” he said.

The standard includes seven  ‘quality statements” that aim to ensure that all adults presenting to a hospital have an assessment of VTE risk and bleeding risk that is formally documented, and that VTE prevention is appropriately prescribed and reviewed.

  1. Assess and document VTE risk.
  2. Develop a VTE prevention plan, balancing the risk of VTE against bleeding.
  3. Inform and partner with patients.
  4. Document and communicate the VTE prevention plan.
  5. Use appropriate VTE prevention methods
  6. Reassess risk and monitor the patient for VTE-related complications.
  7. Transition from hospital and ongoing care.

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