A collaborative effort co-led by a nursing director and involving multiple disciplines across the University of Chicago Medicine, has significantly reduced potentially preventable venous thromboembolisms (VTE) in our patients.
Medical and surgical nurses, staff nurses and nurse assistants as well as physicians, physical therapy, pharmacy, Supply Chain, Support Services, Risk Management and CBIS-EPIC teamed up to assess and address VTE rates in the medical center. A VTE Reduction Task Force convened for the first time in January 2014, kicking off with a LEAN “just do it” event.
Gretchen Pacholek, MSN, RN, Director of Surgical and Multispecialty Services and Vivek Prachand, MD, Chief Quality Officer of the Department of Surgery and Director of Minimally Invasive Surgery, are co-leaders of the project.
“The task force worked in partnership to be sure the message was consistent and that each discipline knew the overall goal and focus,” Prachand said.
Among the initial task force recommendations were the development of care standards and expectations and the purchase of enough alternating leg pressure (ALP) pumps for every patient receiving care in the Center for Care and Discovery, Mitchell and Comer Children’s Hospital.
“Once we had all the pieces of the puzzle, everything happened quickly,” Pacholek said.
Nurse educators raised awareness and trained the nursing staff on the new care expectations.
Supply Chain worked with several nursing units and the Med-Surg Value Analysis Team to conduct a trial testing ALP machines and sleeves from two manufacturers.
“We chose a new supplier based on feedback from the nurses who trialed the products,” explained Dylan Stark, a Sourcing Category Leader in Supply Chain. The purchase of Medline ALP and sleeves also resulted in significant cost savings.
Prachand noted another key adjustment: the opportunity to order chemoprophylaxis and mechanical devices was incorporated directly into all admission and post-operative order sets. “Not only did this serve as a reminder for physicians to consider VTE risk for all of our patients, it also made it easy to order the appropriate measures within the workflow of patient care.”
Pacholek and Stark called the implementation of the initiative flawless. Quality and risk management tracked VTE data. The go-live in May was followed by seven months with no incidence of potentially preventable VTEs among our patients.
“Communication and teamwork among the different disciplines were the keys to success,”
Stark said. Pacholek agrees and called the project one of the best collaborative efforts she has experienced at the medical center.
“The nurses now have the supplies and the training they need to give excellent care to every patient,” she said, “It’s a great start, but in the spirit of LEAN, we’ll work on continuous improvement.”