eMeasure Title Venous Thromboembolism Prophylaxis
eMeasure Identifier
(Measure Authoring Tool)
108 eMeasure Version number 2
NQF Number 0371 GUID 38b0b5ec-0f63-466f-8fe3-2cd20ddd1622
Measurement Period January 1, 20xx through December 31, 20xx
Measure Steward Joint Commission
Measure Developer Joint Commission
Endorsed By National Quality Forum
Description
This measure assesses the number of patients who received VTE prophylaxis or have documentation why no VTE prophylaxis was given the day of or the day after hospital admission or surgery end date for surgeries that start the day of or the day after hospital admission.
Copyright
Measure specifications are in the Public Domain

LOINC(R) is a registered trademark of the Regenstrief Institute.

This material contains SNOMED Clinical Terms (R) (SNOMED CT(c) ) copyright 2004-–2010 International Health Terminology Standards Development Organization. All rights reserved.
Disclaimer
None
Measure Scoring Proportion
Measure Type Process
Stratification
None
Risk Adjustment
None
Rate Aggregation
None
Rationale
Hospitalized patients at high-risk for VTE may develop an asymptomatic deep vein thrombosis (DVT), and die from pulmonary embolism (PE) even before the diagnosis is suspected. Therefore, the best approach is for every patient to be evaluated for primary prophylaxis since preventing DVT is essential to reducing morbidity and mortality associated with PE. There is good evidence that appropriately used thromboprophylaxis has a desirable risk/benefit ratio and is cost-effective. Thromboprophylaxis provides an opportunity to improve patient outcomes and reduce hospital costs. Complications from prophylactic anticoagulation, especially bleeding, have not been supported by the results from many metanalyses and randomized clinical trials. Uniform uses of electronic alerts or local thromboprophylaxis guidelines are associated with improvements in both prophylaxis provision and patients’ outcomes.
Clinical Recommendation Statement
Failure to recognize and protect patients at risk for venous thromboembolism (VTE) increases the chances for acutely ill hospitalized patients at high risk for developing a deep vein thrombosis or dying from a pulmonary emboli. Screening all patients is the only evidence based practice in reducing incidence of disease.  All hospitalized patients should be evaluated for primary VTE prophylaxis, and given appropriate prophylaxis when indicated.
Improvement Notation
An increase in rate
Reference
Geerts WH, Bergqvist D, Pineo GF, Heit JA, Samama CM, Lassen MR, Colwell CW. Prevention of venous thromboembolism. The Eighth ACCP Conference on antithrombotic and thrombolytic therapy. Chest 2008; 133:381S-453S
Reference
Geerts WH, Pineo GF, Heit JA, et al. Prevention of venous thromboembolism: the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest. 2004 Sep;126(3 Suppl):338S-400S
Reference
Kucher N, Koo S, Quiroz R, Cooper JM, et al. (2005). Electronic alerts to prevent venous thromboembolism among hospitalized patients. New England Journal of Medicine, 352(10), 969-1036
Reference
Caprini JA, Arcelus JI. State of the art venous thromboembolism prophylaxis. SCOPE on Phlebology & Lymphology 1:2005, 228-240.
Reference
Michota FA. Venous thromboembolism prophylaxis in medical patients. Curr Opin Cardiol. 2004 Nov;19(6):570-4.
Definition
None
Guidance
The unit of measurement for this measure is an inpatient episode of care. Each distinct hospitalization should be reported, regardless of whether the same patient is admitted for inpatient care more than once during the measurement period. In addition, the eMeasure logic intends to represent events within or surrounding a single occurrence of an inpatient hospitalization.

When unfractionated heparin is not administered due to medical reasons, the intended administration route is subcutaneous.

The facility location arrival datetime and facility location departure datetime are coupled with the emergency department visit value set. They intend to represent arrival date/time at the emergency department and the discharge date/time from the emergency department, respectively.
Transmission Format
None
Initial Patient Population
Patients admitted to the hospital for inpatient acute care with no diagnosis of obstetrics or venous thromboembolism (VTE with hospital stays <= 120 days during the measurement period for patients age 18 and older at the time of hospital admission.
Denominator
All patients in the initial patient population
Denominator Exclusions
Patients who have a length of stay less than 2 days
Patients with comfort measures only documented by the day after hospital admission
Patients with comfort measures only documented by the day after surgery end date for surgeries that start the day of or the day after hospital admission
Patients who are direct admits to intensive care unit (ICU), or transferred to ICU the day of or the day after hospital admission with ICU length of stay greater than or equal to one day
Patients with a principal diagnosis of mental disorders or stroke
Patients with a principal procedure of Surgical Care Improvement Project (SCIP) VTE selected surgeries
Numerator
Patients who received VTE prophylaxis or have documentation why no VTE prophylaxis was given:
-the day of or the day after hospital admission
-the day of or the day after surgery end date for surgeries that start the day of or the day after hospital admission
Numerator Exclusions
Not Applicable
Denominator Exceptions
None
Measure Population
Not Applicable
Measure Observations
Not Applicable
Supplemental Data Elements
For every patient evaluated by this measure also identify payer, race, ethnicity and sex.

Table of Contents


Population criteria

Data criteria (QDM Data Elements)

Reporting Stratification

Supplemental Data Elements




Measure Set
eMeasure Venous Thromboembolism (eVTE)