National Heart, Lung, and Blood Institute (NHLBI)
The goal of this clinical trial is to evaluate whether the implementation of a real-time prognostic model can effectively identify and prevent blood clots among hospitalized patients. The main questions it aims to answer is: 1. Can the prognostic model reduce rates of hospital-acquired blood clots (also known as hospital-acquired venous thromboembolisms)? 2. Is the prognostic model an effective tool for initiating timely and appropriate preventive treatment (i.e., thromboprophylaxis)? Researchers will compare the intervention arm with the control arm (standard of care) to determine whether the intervention reduces rates of blood clots and improves initiation of preventive treatment. The intervention (clinical decision support that displays the prognostic model's output) will be implemented by displaying a risk score in clinicians' workflow in the electronic health record (EHR) to notify clinicians of patients who are at higher risk for sustaining a blood clot. The intervention will not dictate patient care and clinicians will continue to use their clinical knowledge and judgment in their clinical decision-making.
Rationale and Specific Aims In the last 30 years, there has been no significant improvement in rates of venous thromboembolism (VTE). These blood clots develop in the limbs and can travel to the lungs and form pulmonary emboli, which are the most common cause of preventable deaths in the hospital. Currently or recently hospitalized patients account for the majority of VTE cases annually. Failure to recognize and prevent hospital-acquired VTE (HA-VTE) is considered a medical error by the Institute of Medicine. However, the current approach for predicting and preventing HA-VTE among hospitalized…
Inclusion Criteria: * 18 years of age * Admitted to an inpatient setting at Vanderbilt Adult Hospital within study period Exclusion Criteria: * Under the age of 18.
This intervention includes a risk assessment CDS tool that is embedded in EPIC workflow for clinicians. This tool may be located in different areas in EPIC based on clinician role to increase ease of access. The tool, which is based on 17 risk factors, will automatically calculate a patient's risk score and present that risk score to clinicians. Clinicians will have the opportunity to review this risk score during their risk assessment of patients to help guide decision-making surrounding initiation of prophylaxis (if applicable). Unlike other tools, this tool will update patient risk every 24hours and notify clinicians of the updated risk. This tool will also present for all inpatients at the facility, not just high-risk patients.