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Texas Health Presbyterian Hospital Dallas Part of Landmark Study to Encourage Blood Clot Prevention Best Practices
04/25/2011

DALLAS — Researchers at Texas Health Presbyterian Hospital Dallas were part of a recent study that aims to redefine the way hospitals identify and prevent potentially deadly blood clots.

Blood clots, also known as venous thromboembolisms (VTE), are the leading preventable cause of in-hospital deaths in the U.S., claiming an estimated 300,000 lives each year.

The study, published in the American Journal of Medicine, looked at 9,257 patients in 37 U.S. states and found that two-thirds of all hospitalized patients are at-risk for developing a blood clot either in the leg (deep vein thrombosis) or the lung (pulmonary embolism). It concluded that in order to reduce the number of preventable deaths from blood clots, it is critical for hospitals to develop specific, hospital-wide protocols.

In addition to shedding light on the risk for the condition, scientists say the research shows that preventative measures, which have been shown to be effective, aren’t utilized enough.

At Texas Health Dallas, hospital-wide protocols designed to prevent blood clots are “hardwired” into clinical processes by using the electronic health record, or EHR. The EHR, called CareConnect, asks clinicians a series of questions designed to determine the patient’s risk. For patients identified as at-risk for clots, CareConnect then guides the clinician through treatment options, which may include medication therapy and/or the use of mechanical compression stockings to promote blood flow.

“Our goal is prevention by identifying patients who are at risk and implementing preventive measures within 24 hours of admission,” said Phyllis McCorstin, RN, clinical nurse specialist for critical care/cardiology services at Texas Health Dallas. “One tool we use is a Best Practice Alert in our EHR which reminds clinicians to assess the patient’s risk of developing blood clots and to order preventive measures. Another method we use to ensure that all patients who are at risk have the appropriate preventive measures ordered is using a ‘double check process’ when we conduct daily multidisciplinary rounds with the intensivists. In the two years since we implemented these processes, our compliance with using preventive measures has improved from 80 percent to 100 percent.”

The study in the American Journal of Medicine revealed that patients at hospitals such as Texas Health Dallas — larger facilities with residency programs and hospital-wide protocols — had a lower risk of developing clots.

Texas Health Dallas was among 81 hospitals in the nation to participate in the study, which was a follow-up to the ENDORSE trial, a multinational study published in 2008 in The Lancet. That study, in which Texas Health Dallas also participated, helped establish best practices for preventing blood clots.

Researchers say they are hopeful the findings encourage more hospitals to implement strategies to assess all patients for blood clot risk and to take appropriate action to prevent the condition.

“Preventing venous thromboembolism involves simple, inexpensive steps that all hospitals around the world should implement,” said researcher Dr. Gary Weinstein, a pulmonologist on the medical staff at Texas Health Dallas and medical director of critical care medicine. “This research further shows that we have the tools to accurately predict who is at risk for VTE, which can help us better prevent it.”

Dr. Mark Feldman, chairman of internal medicine and medical director of research at Texas Health Dallas, was the principal investigator for the ENDORSE trial at Texas Health Dallas.

“The ENDORSE trial showed us that complications can be reduced if hospitals implement these steps,” he said. “The follow-up study showed us that shedding light on this topic has caused more hospitals to adopt protocols that make those steps part of their daily routine. And that is saving lives.”

About Texas Health Presbyterian Hospital Dallas
Texas Health Presbyterian Hospital Dallas is an 866-bed acute care hospital and recognized clinical program leader, having provided compassionate care to the residents of Dallas and surrounding communities since 1966. U.S. News and World Report has ranked Texas Health Dallas among the nation’s best hospitals in digestive disorders, orthopedics, and neurology and neurosurgery. An affiliate of the faith-based, nonprofit Texas Health Resources system, Texas Health Dallas has approximately 4,000 employees and an active medical staff of more than 1,000 physicians. For more information, call 1-877-THR-WELL, or visit TexasHealth.org/Dallas.

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