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Professional Treatment Guidelines
Organizations Monitoring Quality Care
Joint Commission on Accreditation of Healthcare Organizations (JCAHO)
www.jcaho.org
A not-for-profit healthcare accreditation organization that issues performance-based standards and assesses organizational compliance to improve patient safety and quality of care.
Leapfrog Group
www.leapfroggroup.org
An initiative of
health-care purchasing organizations seeking improvements in safety,
quality and affordability of health care, with funding from the
Business Roundtable, Robert Wood Johnson Foundation and member
organizations.
National Quality Forum
www.qualityforum.org
A not-for-profit that develops and implements national strategies for healthcare quality measurement and reporting.
Despite widespread efforts to educate health care professionals
about venous thromboembolism (VTE) prevention and treatment, and
the publication of numerous clinical guidelines, VTE prevention
measure are not widely or consistently used outside of the
intensive care unit. The failure to assess, diagnose, and treat
is especially true for people who are at low-to-moderate risk of
developing VTE.61
While there are numerous VTE standards and guidelines developed
for specific healthcare settings (such as a hospital intensive
care units) or medical practitioners (such as specialists in the
chest area), there are no nationally recognized VTE performance
measures that can be applied to a variety of healthcare
settings.
The lack of prevention standards will soon change. The National Quality
Forum (NQF) is working on developing national consensus standards
for VTE prevention and care for other healthcare settings. The outcome
will include:
- Performance measures to evaluate the quality of care for persons at risk for VTE, including DVT and PE
- A framework for measuring effective screening, prevention, and treatment of VTE
NQF plans to endorse a policy on prevention and care identifying
preferred practices and describing organizational policy for the
prevention and care of persons at risk for VTE.62 NQF's recommendations
for organizational policies will address staff education, treatment
protocols and adherence measurements to improve VTE prevention in the
hospital.
Upon endorsement of the policy, NQF will advocate and encourage in every
applicable care setting the adoption and use of the organizational
policy, preferred practices and performance measures.
The National Quality Forum (NQF) and Leapfrog Group have already
endorsed the inclusion of venous thrombosis prevention among the "safe
practice" recommendations issued by the Joint Commission on
Accreditation of Health Care Organizations (JCAHO). With assistance from
NQF, JCAHO is developing performance measures to implement these
recommendations.
For more information on the 30 "safe practices" for better health care, visit:
www.qualityforum.org/txDVTprojectsummaryFINAL.pdf.
Organizations with Professional Guidelines on DVT
61 CLOT (Cost-Lowering Options for Optimizing Thromboprophylaxis) Clinical Consensus Panel. (Dec. 1, 2004) “Optimizing Anticoagulation Technology in the Hospital Setting – Safe and Cost-Effective Strategies for Thrombosis Prophylaxis and Treatment.” Hospital Medical Consensus Reports. Available on the World Wide Web: www.clinicalconsensusreports.com/Secure/CLOT122004.pdf#search='Findings%20and%20Recommendations%20of%20The%20CLOT%20(CostLowering%20Options%20for%20Optimizing%20Thromboprophylaxis)%20Clinical%20Consensus%20Panel.
62 National Quality Forum. (January 2006) "NQF Project Brief: National Voluntary Consensus Standards for the Prevention and Care of Venous Thromboembolism, Including Deep-Vein Thrombosis and Pulmonary Embolism.” Available on the World Wide Web: www.qualityforum.org/txDVTprojectsummaryFINAL.pdfM.
63 Geerts, W.H., et al. (2004) “Prevention of Venous Thromboembolism: The Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy.” Chest 126(suppl):338S-400S.
64 American College of Emergency Physicians. (July 2003) “Clinical Policy: Critical Issues in the Evaluation and Management of Adult Patients Presenting with Suspected Lower-Extremity Deep Venous Thrombosis.” Annals of Emergency Medicine 42:124-135.
65 American Heart Association/American College of Cardiology Foundation (2003) “Guide to Warfarin Therapy.” Circulation 107:1692.
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