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Organizing Your Program
Example 1. Screening Program Developed by the American Venous Forum and the American Vascular Association
What do you want to accomplish?
The goal of the two organizations was to conduct screenings nationwide
for venous conditions, providing the same quality and type of exam as
would be provided in a vascular specialty laboratory or medical
facility. An outcome of the event would be a well-developed toolkit for
doctors at the screening sites that would include data management tools,
patient consent forms, media communication guidelines, key messages,
question and answer sheets, resources and general information.
Who is the audience?
The primary audience is adults over the age of 40 who have contributing
factors for deep vein thrombosis (DVT), have leg pain or swelling, and
have an established venous disease. Examples include people who have
visible varicose veins or a family history of DVT.
What do you want to say to your audience?
- DVT is a public health risk that has a significant impact on an aging population.
- Know the risk factors that prompt the development of a DVT.
- Know the steps you can take to minimize the risk of developing a DVT.
How do you get from the plan to the program?
The operation of such an ambitious program moves through a series of
steps, each one generating a series of questions to answer.
Step 1. What?
Decide what format or means you want to use to communicate your
messages.
The American Venous Forum (AVF) and the American Vascular Association
(AVA) decided that doing a visible activity would bring attention to the
issue of DVT. The first-ever public venous screening programs were held
at 17 sites in 2005 during National Venous Health Week (the second week
in November). AVF and AVA chose a free activity that involved
professionals and the community centered on a nationally recognized
event that in the past had generated publicity.
The new National Screening Program for Venous Disease was patterned
after AVA's screening program for arterial disease, which includes
peripheral artery disease (diseases of arteries in the arms and legs),
abdominal aortic aneurysm (bleeding of a large artery below the stomach)
and carotid (neck) artery disease. That national screening program has
helped focus public attention on arterial vascular disease, and has
reached more than 8,000 people age 55 and over.
The new effort was intended to create national awareness about venous
problems, which include venous thrombosis, varicose veins and chronic
venous insufficiency (too little blood flow in the veins).
The screening program took 10-15 minutes per patient and was the largest
and most comprehensive venous disease screening ever undertaken. There
were four basic components:
- DVT risk assessment score using a standard assessment tool
- Brief ultrasound exam (sound waves detecting blockages) of veins in the leg to see if there is any damage to a major vein
- Physical examination of the patient's legs, looking for spider veins, varicose veins, swelling, skin changes, healed sores and open sores
- Exit interview with a qualified vascular surgeon or specialist who looks over the findings for the patient and writes a "Venous Report Card" for the patient to take to his or her doctor
Patients received follow-up calls one or two weeks later to see if they
had contacted their doctors with the results.
Step 2. Where?
Find a safe, comfortable and convenient location.
Individual screening sites, generally a hospital or medical center, did
their own outreach to recruit people for screening. Since each medical
facility can ideally handle 40-60 screenings a day, the marketing and
outreach approaches were carefully considered so that each location
could handle the demand and not be overextended.
Step 3. Who?
Choose partners nationally and locally.
The two national organizations have a shared mission to increase
understanding about venous disease, and reduce death and disability.
These organizations want to see venous disease become a national
healthcare priority similar to the work done for arterial disease.
AVF is a nonprofit medical society formed by venous and lymphatic
specialists dedicated to improving patient care through education and
information exchange. AVA is an independent not-for-profit foundation
associated with the Society for Vascular Surgery. AVA was created to
reduce death and disability related to vascular disease through research
and education.
Local partners were recruited by the national organizations from their members.
Step 4. How?
Determine how to publicize the program.
Local sites conducted outreach through their usual channels of public
information. The national organizations plan to do public information
campaigns before the next screening in November for National Venous
Health Week. The program staff had begun site recruitment and awareness
building by announcing the results of the first national screening for
venous thrombosis at the national professional meeting, the American
Venous Forum.
Step 5. So What?
Measure the success of the program and set new goals.
How the program is evaluated begins in the planning stage with careful
follow-through on site. The National Screening for VTE reached 476
people at 17 centers in 2005. Of the 476 patients screened, 77% were at
high or very high risk of developing a thrombosis, 20% had varicose
veins or swelling that required use of support stockings, and 40% had
evidence of abnormal valve function in the veins. The procedures and the
data are still undergoing analysis.
Future goals of the AVF include providing continuing medical education
credits to doctors located near the participating sites. AVA hopes to
educate doctors who receive a patient's Venous Report Card about what to
do with the information and how to treat these patients.
For more information on future campaigns, contact AVF:
Phone: (978) 744-5005
E-mail: eila@administrare.com
Website: www.americanvenousforum.com/
Or contact Michele Lentz at AVA:
Phone: (410) 553-6008 or toll-free (877) AVA-2010
E-mail: mlentzAVA@cablespeed.com
Website: www.vascularweb.org/_CONTRIBUTION_PAGES/AVA_Screening/AVF_Venous_Screening_Center.html
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