NQMC Update Service: August 13, 2012 ►Institute for Clinical Systems Improvement ► Venous thromboembolism (VTE) diagnosis and treatment

Institute for Clinical Systems Improvement

• Venous thromboembolism (VTE) diagnosis and treatment: percentage of adult patients with deep vein thrombosis who have been assessed for the need for graduated compression stockings (not Teds). This updates a previously published measure summary.

• Venous thromboembolism (VTE) diagnosis and treatment: percentage of hospitalized patients with deep vein thrombosis who receive warfarin on day one of heparin therapy.

• Venous thromboembolism (VTE) diagnosis and treatment: percentage of patients diagnosed with VTE who have had a D-dimer test.

• Venous thromboembolism (VTE) diagnosis and treatment: percentage of patients diagnosed with VTE who meet the criteria for LMWH and for whom LMWH is used. This updates a previously published measure summary.

• Venous thromboembolism (VTE) diagnosis and treatment: percentage of patients diagnosed with VTE, DVT, or PE for which a complete list of medications was communicated to the next provider of service when the patient was referred or transferred to another care setting.

• Venous thromboembolism (VTE) diagnosis and treatment: percentage of patients suspected of DVT who have leg duplex ultrasound with compression performed despite a low clinical pretest probability and a negative D-dimer test. This updates a previously published measure summary.

• Venous thromboembolism (VTE) diagnosis and treatment: percentage of patients who have a high clinical pretest probability for PE who received LMWH during evaluation. This updates a previously published measure summary.

• Venous thromboembolism (VTE) diagnosis and treatment: percentage of patients with suspected VTE who have a clinical pretest probability assessment completed.

• Venous thromboembolism (VTE) diagnosis and treatment: percentage of patients with VTE receiving heparin therapy who have a baseline platelet count before starting heparin, and then a platelet count every other day for at least the first three days of therapy. This updates a previously published measure summary.

• Venous thromboembolism (VTE) diagnosis and treatment: percentage of patients with VTE treated with LMWH who receive heparin treatment for at least five days after the initiation of warfarin therapy and until INR is greater than or equal to 2.0 for two consecutive days.

• Venous thromboembolism (VTE) diagnosis and treatment: percentage of patients with VTE treated with UFH who receive heparin treatment for at least five days after the initiation of warfarin therapy and until INR is greater than or equal to 2.0 for two consecutive days.

• Venous thromboembolism (VTE) diagnosis and treatment: percentage of patients with VTE who are initially prescribed anticoagulation therapy with documentation in the medical record indicating a baseline INR was obtained.

• Venous thromboembolism (VTE) diagnosis and treatment: percentage of patients with VTE who are prescribed heparin and LMWH, who have appropriate ongoing laboratory tests available to monitor and adjust therapy.

• Venous thromboembolism (VTE) diagnosis and treatment: percentage of patients with VTE who are prescribed UFH and/or LMWH, who have appropriate baseline laboratory tests documented in their medical record.

• Venous thromboembolism (VTE) diagnosis and treatment: percentage of patients with VTE who develop pulmonary embolism.

• Venous thromboembolism (VTE) diagnosis and treatment: percentage of patients with VTE who have been treated with anticoagulation therapy for three to six months, having been reevaluated for ongoing risk factors to determine the need for ongoing therapy.

Venous thromboembolism (VTE) diagnosis and treatment: percentage of patients with VTE who receive ongoing anticoagulation therapy with documentation in the medical record indicating a current INR is available and is used to monitor and adjust therapy.