Clinical Transformation of an adult VTE Risk Assessment form

Why?

NICE and the VTE Exemplar Centres guidelines advises:

• 95% of patients should be risk assessed for:

• Venous thromboembolism (VTE) risk

• Bleeding risk

Internal Trust audits of VTE Risk Assessment compliance shows a range of completion as low as 70%.

Aim

1. Create a single standardised digital VTE Risk Assessment

2. Provide safe up to date clinical decision support (Fig 2.)

3. Improve completion compliance to meet national 4. improve patient choice faith and non 5. Improve patient 6. Support clinical teams to decommission paper forms

7. Future proof for future changes

Clinically led Transformation

Audit

Clinically led transformation:

The informatics team followed a cycle of transformation (Fig 1.) to design and implement a solution within the constraints of the system

Collaboration and engagement with:

• key stakeholders

• users

• Patients

Project Results

75% of the paper forms do not follow BNF & Trust guidance for pharmacological thromboprophylaxis. 0% of forms mention Fondaparinux as an alternative not containing animal

Feedback gathered & reviewed Collaboratively design the next iteration of the form. Roll out to more trust areas - Target compliance 95%

Launch digital VTE Risk assessment form, and flow board compliance indicator. Target compliance of 95%. Results Compliance of 88-91% (baseline improvement 18%).

Current and future state process maps (Fig. 3). A draft VTE Risk Assessment form was collaboratively designed

Review of all paper VTE Risk Assessments in use. Analyse the findings (Fig. 4,5,6). Make recommendation for change