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  • Measure Summary
  • NQMC:008327
  • Nov 2012

Venous thromboembolism (VTE) prophylaxis: percentage of adult hospitalized patients receiving heparin therapy for VTE prophylaxis who have a baseline platelet count before starting heparin and then a platelet count every other day over the course of 14 days.

Jobin S, Kalliainen L, Adebayo L, Agarwal Z, Card R, Christie B, Haland T, Hartmark M, Johnson P, Kang M, Lindvall B, Mohsin S, Morton C. Venous thromboembolism prophylaxis. Bloomington (MN): Institute for Clinical Systems Improvement (ICSI); 2012 Nov. 51 p. [22 references]

View the original measure documentation External Web Site Policy

This is the current release of the measure.

This measure updates a previous version: Institute for Clinical Systems Improvement (ICSI). Venous thromboembolism prophylaxis. Bloomington (MN): Institute for Clinical Systems Improvement (ICSI); 2011 Sep. 47 p.

The measure developer reaffirmed the currency of this measure in January 2016.

Primary Measure Domain

Clinical Quality Measures: Process

Secondary Measure Domain

Does not apply to this measure

Description

This measure is used to assess the percentage of adult hospitalized patients 18 years and older receiving heparin therapy for venous thromboembolism prophylaxis who have a baseline platelet count before starting heparin and then a platelet count every other day over the course of 14 days.

Rationale

The priority aim addressed by this measure is to reduce the risk of complications from pharmacologic thromboprophylaxis for hospitalized and discharged patients 18 years of age and older.

Evidence for Rationale

Jobin S, Kalliainen L, Adebayo L, Agarwal Z, Card R, Christie B, Haland T, Hartmark M, Johnson P, Kang M, Lindvall B, Mohsin S, Morton C. Venous thromboembolism prophylaxis. Bloomington (MN): Institute for Clinical Systems Improvement (ICSI); 2012 Nov. 51 p. [22 references]

Primary Health Components

Venous thromboembolism (VTE); prophylaxis; anticoagulant therapy; heparin; baseline platelet count

Denominator Description

Number of adult patients who are hospitalized for a medical condition or surgery and receiving heparin therapy for venous thromboembolism prophylaxis (see the related "Denominator Inclusions/Exclusions" field)

Numerator Description

Number of adult patients hospitalized for a medical condition or surgery and on heparin therapy for venous thromboembolism prophylaxis who have a baseline platelet count before starting heparin and then a platelet count every other day over the course of 14 days

Type of Evidence Supporting the Criterion of Quality for the Measure

  • A clinical practice guideline or other peer-reviewed synthesis of the clinical research evidence

Additional Information Supporting Need for the Measure

Unspecified

Extent of Measure Testing

Unspecified

State of Use

Current routine use

Current Use

Internal quality improvement

Measurement Setting

Hospital Inpatient

Professionals Involved in Delivery of Health Services

Physicians

Least Aggregated Level of Services Delivery Addressed

Single Health Care Delivery or Public Health Organizations

Statement of Acceptable Minimum Sample Size

Unspecified

Target Population Age

Age greater than or equal to 18 years

Target Population Gender

Either male or female

National Quality Strategy Aim

Better Care

National Quality Strategy Priority

Health and Well-being of Communities
Making Care Safer
Prevention and Treatment of Leading Causes of Mortality

IOM Care Need

Getting Better

Staying Healthy

IOM Domain

Effectiveness

Safety

Case Finding Period

The time frame pertaining to data collection is monthly.

Denominator Sampling Frame

Patients associated with provider

Denominator (Index) Event or Characteristic

Institutionalization

Patient/Individual (Consumer) Characteristic

Therapeutic Intervention

Denominator Time Window

Does not apply to this measure

Denominator Inclusions/Exclusions

Inclusions
Number of adult patients who are hospitalized for a medical condition or surgery and receiving heparin therapy for venous thromboembolism prophylaxis

Population Definition: Patients 18 years of age and older.

Data Collection: From discharge records, a list of all adult patients hospitalized during the target period.

Exclusions
Unspecified

Exclusions/Exceptions

Unspecified

Numerator Inclusions/Exclusions

Inclusions
Number of adult patients hospitalized for a medical condition or surgery and on heparin therapy for venous thromboembolism prophylaxis who have a baseline platelet count before starting heparin and then a platelet count every other day over the course of 14 days

Exclusions
Unspecified

Numerator Search Strategy

Institutionalization

Data Source

Paper medical record

Type of Health State

Does not apply to this measure

Instruments Used and/or Associated with the Measure

Unspecified

Measure Specifies Disaggregation

Does not apply to this measure

Scoring

Rate/Proportion

Interpretation of Score

Desired value is a higher score

Allowance for Patient or Population Factors

Unspecified

Standard of Comparison

Internal time comparison

Original Title

Percentage of adult hospitalized patients receiving heparin therapy for venous thromboembolism prophylaxis who have a baseline platelet count before starting heparin, and then a platelet count every other day over the course of 14 days.

Measure Collection Name

Venous Thromboembolism Prophylaxis

Submitter

Institute for Clinical Systems Improvement - Nonprofit Organization

Developer

Institute for Clinical Systems Improvement - Nonprofit Organization

Funding Source(s)

The Institute for Clinical Systems Improvement's (ICSI's) work is funded by the annual dues of the member medical groups and five sponsoring health plans in Minnesota and Wisconsin.

Composition of the Group that Developed the Measure

Work Group Members: Sherri Jobin, PharmD, BCPS (Work Group Co-Leader) (HealthEast Care System); Loree K. Kalliainen, MD, MA (Work Group Co-Leader) (HealthPartners Medical Group and Regions Hospital) (Plastic Surgeon); Randall Card, MD (Cuyuna Regional Medical Center) (Family Medicine); Beverly Christie, RN, DNP, PHN (Fairview Health Services) (Quality and Patient Safety); Martina E. Hartmark, MD (HealthPartners Medical Group and Regions Hospital) (Internal Medicine); Matthew Kang, MD (HealthPartners Medical Group and Regions Hospital) (Neurosurgery); Salma Mohsin, MD (HealthPartners Medical Group and Regions Hospital) (Hospitalist); Colleen Morton, MD (HealthPartners Medical Group and Regions Hospital) (Hematology); Ted Haland, MD (Lakeview Medical Center) (Hospitalist); Linda Adebayo, MSN, RN (Marshfield Clinic) (Internal Medicine, Institute for Quality, Innovation and Patient Safety); Zubin Agarwal, MD, MPH (Mayo Clinic) (Internal Medicine); Paul Johnson, MD (Park Nicollet HealthServices) (Orthopedic Surgery); Britta Lindvall, MHA (Institute for Clinical Systems Improvement) (Project Manager)

Financial Disclosures/Other Potential Conflicts of Interest

The Institute for Clinical Systems Improvement (ICSI) has long had a policy of transparency in declaring potential conflicting and competing interests of all individuals who participate in the development, revision and approval of ICSI guidelines and protocols.

In 2010, the ICSI Conflict of Interest Review Committee was established by the Board of Directors to review all disclosures and make recommendations to the board when steps should be taken to mitigate potential conflicts of interest, including recommendations regarding removal of work group members. This committee has adopted the Institute of Medicine Conflict of Interest standards as outlined in the report Clinical Practice Guidelines We Can Trust (2011).

Where there are work group members with identified potential conflicts, these are disclosed and discussed at the initial work group meeting. These members are expected to recuse themselves from related discussions or authorship of related recommendations, as directed by the Conflict of Interest committee or requested by the work group.

The complete ICSI policy regarding Conflicts of Interest is available at the ICSI Web site External Web Site Policy.

Disclosure of Potential Conflicts of Interest

Linda Adebayo, MSN, RN (Work Group Member)
Quality Improvement and Care Management, Marshfield Clinic
National, Regional, Local Committee Affiliations: None
Guideline-Related Activities: ICSI Prevention and Diagnosis of Obesity Guideline
Research Grants: None
Financial/Non-Financial Conflicts of Interest: None

Zubin Agarwal, MPH (Work Group Member)
Medical Student, Mayo Clinic
National, Regional, Local Committee Affiliations: None
Guideline-Related Activities: None
Research Grants: None
Financial/Non-Financial Conflicts of Interest: None

Randall Card, MD (Work Group Member)
Physician, Family Medicine, Cuyuna Regional Medical Group
National, Regional, Local Committee Affiliations: None
Guideline-Related Activities: ICSI Pre-Operative Evaluation Guideline
Research Grants: None
Financial/Non-Financial Conflicts of Interest: None

Beverly Christie, RN, DNP, PHN (Work Group Member)
Senior Director of Integrated Quality and Patient Safety, Fairview Health Services
National, Regional, Local Committee Affiliations: None
Guideline-Related Activities: None
Research Grants: None
Financial/Non-Financial Conflicts of Interest: None

Ted Haland, MD (Work Group Member)
Physician, Family Medicine, Stillwater Medical Group, HealthPartners Medical Group and Regions Hospital
National, Regional, Local Committee Affiliations: None
Guideline-Related Activities: None
Research Grants: None
Financial/Non-Financial Conflicts of Interest: None

Martina Hartmark, MD (Work Group Member)
Physician, Internal Medicine, HealthPartners Medical Group and Regions Hospital
National, Regional, Local Committee Affiliations: None
Guideline-Related Activities: None
Research Grants: None
Financial/Non-Financial Conflicts of Interest: None

Sherri Jobin, PharmD, BCPS (Work Group Co-Leader)
Clinical Pharmacy Coordinator, Pharmacotherapy, HealthEast Care System
National, Regional, Local Committee Affiliations: None
Guideline-Related Activities: None
Research Grants: None
Financial/Non-Financial Conflicts of Interest: Husband works for Abbott Labs, which does not make pharmaceuticals for VTE prophylaxis

Paul Johnson, MD (Work Group Member)
Orthopedics, Park Nicollet Health Services
National, Regional, Local Committee Affiliations: None
Guideline-Related Activities: None
Research Grants: None
Financial/Non-Financial Conflicts of Interest: None

Loree Kalliainen, MD, FACS (Work Group Co-Leader)
Surgeon, Department of Plastic and Hand Surgery, HealthPartners Medical Group and Regions Hospital
National, Regional, Local Committee Affiliations: None
Guideline-Related Activities: Served on guidelines with American Society of Plastic Surgery and the American Academy of Orthopedic Surgery
Research Grants: Worked on behalf of her organization on grants with the Plastic Surgery Foundation and NIH
Financial/Non-Financial Conflicts of Interest: None

Matthew Kang, MD (Work Group Member)
Neurosurgeon, Neurosurgery, HealthPartners Medical Group and Regions Hospital
National, Regional, Local Committee Affiliations: None
Guideline-Related Activities: None
Research Grants: None
Financial/Non-Financial Conflicts of Interest: None

Colleen Morton, MD (Work Group Member)
Hematology/Oncology, HealthPartners Medical Group and Regions Hospital
National, Regional, Local Committee Affiliations: None
Guideline-Related Activities: ICSI Antithrombotic Therapy Supplement
Research Grants: None
Financial/Non-Financial Conflicts of Interest: None

Salma Mohsin, MD (Work Group Member)
Hospitalist, HealthPartners Medical Group and Regions Hospital
National, Regional, Local Committee Affiliations: None
Guideline-Related Activities: None
Research Grants: None
Financial/Non-Financial Conflicts of Interest: None

Adaptation

This measure was not adapted from another source.

Date of Most Current Version in NQMC

2012 Nov

Measure Maintenance

Scientific documents are revised every 12 to 24 months as indicated by changes in clinical practice and literature.

Date of Next Anticipated Revision

The next scheduled revision will occur within 12 months.

Measure Status

This is the current release of the measure.

This measure updates a previous version: Institute for Clinical Systems Improvement (ICSI). Venous thromboembolism prophylaxis. Bloomington (MN): Institute for Clinical Systems Improvement (ICSI); 2011 Sep. 47 p.

The measure developer reaffirmed the currency of this measure in January 2016.

Source(s)

Jobin S, Kalliainen L, Adebayo L, Agarwal Z, Card R, Christie B, Haland T, Hartmark M, Johnson P, Kang M, Lindvall B, Mohsin S, Morton C. Venous thromboembolism prophylaxis. Bloomington (MN): Institute for Clinical Systems Improvement (ICSI); 2012 Nov. 51 p. [22 references]

Measure Availability

Source available from the Institute for Clinical Systems Improvement (ICSI) Web site External Web Site Policy.

For more information, contact ICSI at 8009 34th Avenue South, Suite 1200, Bloomington, MN 55425; Phone: 952-814-7060; Fax: 952-858-9675; Web site: www.icsi.org External Web Site Policy; E-mail: icsi.info@icsi.org.

NQMC Status

This NQMC summary was completed by ECRI Institute on March 21, 2011.

This NQMC summary was retrofitted into the new template on July 22, 2011.

This NQMC summary was updated by ECRI Institute on October 9, 2012 and again on June 11, 2013.

The information was reaffirmed by the measure developer on January 13, 2016.

Copyright Statement

This NQMC summary (abstracted Institute for Clinical Systems Improvement [ICSI] Measure) is based on the original measure, which is subject to the measure developer's copyright restrictions.

The abstracted ICSI Measures contained in this Web site may be downloaded by any individual or organization. If the abstracted ICSI Measures are downloaded by an individual, the individual may not distribute copies to third parties.

If the abstracted ICSI Measures are downloaded by an organization, copies may be distributed to the organization's employees but may not be distributed outside of the organization without the prior written consent of the Institute for Clinical Systems Improvement, Inc.

All other copyright rights in the abstracted ICSI Measures are reserved by the Institute for Clinical Systems Improvement, Inc. The Institute for Clinical Systems Improvement, Inc. assumes no liability for any adaptations or revisions or modifications made to the abstracts of the ICSI Measures.

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