Assessment of the Effect on Thromboprophylaxis with Multifaceted Quality Improvement Intervention based on Clinical Decision Support System in Hospitalized Patients: A Pilot Study
Background: To explore the feasibility and effectiveness of multifaceted quality improvement intervention based on the clinical decision support system (CDSS) in VTE prophylaxis in hospitalized patients. Methods: A randomized, department-based clinical trial was conducted in the department of respir...
| Main Authors: | , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-08-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/17/4997 |
| _version_ | 1797494833689919488 |
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| author | Qian Gao Kaiyuan Zhen Lei Xia Wei Wang Yaping Xu Chaozeng Si Zhu Zhang Fen Dong Jieping Lei Peiran Yang Jixiang Liu Ziyi Sun Tieshan Zhang Jun Wan Wanmu Xie Peng Liu Cunbo Jia Zhenguo Zhai Chen Wang |
| author_facet | Qian Gao Kaiyuan Zhen Lei Xia Wei Wang Yaping Xu Chaozeng Si Zhu Zhang Fen Dong Jieping Lei Peiran Yang Jixiang Liu Ziyi Sun Tieshan Zhang Jun Wan Wanmu Xie Peng Liu Cunbo Jia Zhenguo Zhai Chen Wang |
| author_sort | Qian Gao |
| collection | DOAJ |
| description | Background: To explore the feasibility and effectiveness of multifaceted quality improvement intervention based on the clinical decision support system (CDSS) in VTE prophylaxis in hospitalized patients. Methods: A randomized, department-based clinical trial was conducted in the department of respiratory and critical care medicine, orthopedic, and general surgery wards. Patients aged ≥18 years, without VTE in admission, were allocated to the intervention group and received regular care combined with multifaceted quality improvement intervention based on CDSS during hospitalization. VTE prophylaxis rate and the occurrence of hospital-associated VTE events were analyzed as primary and secondary outcomes. Results: A total of 3644 eligible residents were enrolled in this trial. With the implementation of the multifaceted quality improvement intervention based on the CDSS, the VTE prophylaxis rate of the intervention group increased from 22.93% to 34.56% (<i>p</i> < 0.001), and the incidence of HA-VTE events increased from 0.49% to 1.00% (<i>p</i> = 0.366). In the nonintervention group, the VTE prophylaxis rate increased from 24.49% to 27.90% (<i>p</i> = 0.091), and the incidence of HA-VTE events increased from 0.47% to 2.02% (<i>p</i> = 0.001). Conclusions: Multifaceted quality improvement intervention based on the CDSS strategy is feasible and expected to facilitate implementation of the recommended VTE prophylaxis strategies and reduce the incidence of HA-VTE in hospital. However, it is necessary to conduct more multicenter clinical trials in the future to provide more reliable real-world evidence. |
| first_indexed | 2024-03-10T01:39:59Z |
| format | Article |
| id | doaj.art-05ccf300bd084cab9edd9c0a16ac6ac8 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T01:39:59Z |
| publishDate | 2022-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-05ccf300bd084cab9edd9c0a16ac6ac82023-11-23T13:25:53ZengMDPI AGJournal of Clinical Medicine2077-03832022-08-011117499710.3390/jcm11174997Assessment of the Effect on Thromboprophylaxis with Multifaceted Quality Improvement Intervention based on Clinical Decision Support System in Hospitalized Patients: A Pilot StudyQian Gao0Kaiyuan Zhen1Lei Xia2Wei Wang3Yaping Xu4Chaozeng Si5Zhu Zhang6Fen Dong7Jieping Lei8Peiran Yang9Jixiang Liu10Ziyi Sun11Tieshan Zhang12Jun Wan13Wanmu Xie14Peng Liu15Cunbo Jia16Zhenguo Zhai17Chen Wang18Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing 100029, ChinaDepartment of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing 100029, ChinaMedical Affairs Department of China-Japan Friendship Hospital, Beijing 100029, ChinaDepartment of Nursing, China-Japan Friendship Hospital, Beijing 100029, ChinaDepartment of Nursing, China-Japan Friendship Hospital, Beijing 100029, ChinaDepartment of Information Management, China-Japan Friendship Hospital, Beijing 100029, ChinaDepartment of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing 100029, ChinaInstitute of Clinical Medical Sciences, China-Japan Friendship Hospital, Beijing 100029, ChinaInstitute of Clinical Medical Sciences, China-Japan Friendship Hospital, Beijing 100029, ChinaDepartment of Physiology, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100730, ChinaDepartment of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing 100029, ChinaChina-Japan Friendship Hospital, Beijing 100029, ChinaDepartment of Information Management, China-Japan Friendship Hospital, Beijing 100029, ChinaDepartment of Pulmonary and Critical Care Medicine, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, ChinaDepartment of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing 100029, ChinaDepartment of Cardiovascular Surgery, China-Japan Friendship Hospital, Beijing 100029, ChinaChina-Japan Friendship Hospital, Beijing 100029, ChinaDepartment of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing 100029, ChinaDepartment of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing 100029, ChinaBackground: To explore the feasibility and effectiveness of multifaceted quality improvement intervention based on the clinical decision support system (CDSS) in VTE prophylaxis in hospitalized patients. Methods: A randomized, department-based clinical trial was conducted in the department of respiratory and critical care medicine, orthopedic, and general surgery wards. Patients aged ≥18 years, without VTE in admission, were allocated to the intervention group and received regular care combined with multifaceted quality improvement intervention based on CDSS during hospitalization. VTE prophylaxis rate and the occurrence of hospital-associated VTE events were analyzed as primary and secondary outcomes. Results: A total of 3644 eligible residents were enrolled in this trial. With the implementation of the multifaceted quality improvement intervention based on the CDSS, the VTE prophylaxis rate of the intervention group increased from 22.93% to 34.56% (<i>p</i> < 0.001), and the incidence of HA-VTE events increased from 0.49% to 1.00% (<i>p</i> = 0.366). In the nonintervention group, the VTE prophylaxis rate increased from 24.49% to 27.90% (<i>p</i> = 0.091), and the incidence of HA-VTE events increased from 0.47% to 2.02% (<i>p</i> = 0.001). Conclusions: Multifaceted quality improvement intervention based on the CDSS strategy is feasible and expected to facilitate implementation of the recommended VTE prophylaxis strategies and reduce the incidence of HA-VTE in hospital. However, it is necessary to conduct more multicenter clinical trials in the future to provide more reliable real-world evidence.https://www.mdpi.com/2077-0383/11/17/4997Venous thromboembolismquality improvementVTE prophylaxis |
| spellingShingle | Qian Gao Kaiyuan Zhen Lei Xia Wei Wang Yaping Xu Chaozeng Si Zhu Zhang Fen Dong Jieping Lei Peiran Yang Jixiang Liu Ziyi Sun Tieshan Zhang Jun Wan Wanmu Xie Peng Liu Cunbo Jia Zhenguo Zhai Chen Wang Assessment of the Effect on Thromboprophylaxis with Multifaceted Quality Improvement Intervention based on Clinical Decision Support System in Hospitalized Patients: A Pilot Study Journal of Clinical Medicine Venous thromboembolism quality improvement VTE prophylaxis |
| title | Assessment of the Effect on Thromboprophylaxis with Multifaceted Quality Improvement Intervention based on Clinical Decision Support System in Hospitalized Patients: A Pilot Study |
| title_full | Assessment of the Effect on Thromboprophylaxis with Multifaceted Quality Improvement Intervention based on Clinical Decision Support System in Hospitalized Patients: A Pilot Study |
| title_fullStr | Assessment of the Effect on Thromboprophylaxis with Multifaceted Quality Improvement Intervention based on Clinical Decision Support System in Hospitalized Patients: A Pilot Study |
| title_full_unstemmed | Assessment of the Effect on Thromboprophylaxis with Multifaceted Quality Improvement Intervention based on Clinical Decision Support System in Hospitalized Patients: A Pilot Study |
| title_short | Assessment of the Effect on Thromboprophylaxis with Multifaceted Quality Improvement Intervention based on Clinical Decision Support System in Hospitalized Patients: A Pilot Study |
| title_sort | assessment of the effect on thromboprophylaxis with multifaceted quality improvement intervention based on clinical decision support system in hospitalized patients a pilot study |
| topic | Venous thromboembolism quality improvement VTE prophylaxis |
| url | https://www.mdpi.com/2077-0383/11/17/4997 |
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