1. Diagnostic QI Repository
  2. SIDM-IHI Learning Collaborative

Medstar Health

About the Medstar Health Site Project

Project Leads: Melanie Powell, MD, Tony Calabria  

The VTE advisor is a mandatory clinical decision support tool embedded in the EMR, designed to help physicians risk stratify patients for venous thromboembolism (VTE) and guide VTE prophylaxis recommendations. It is the only decision support tool that is part of the admission order set. Acceptance and appropriate use of the tool have been low for a variety of reasons (the perception that it is too time-consuming to use, poor functionality during the initial rollout, lack of knowledge about its purpose, lack of buy-in to the value of decision support, etc.). The medical intermediate care unit, for instance, audit of VTE advisor completion during the month of November revealed that 60% of the patients were characterized as low risk. Moreover, when the tool is used, it is often completed incorrectly or overridden. It was believed that among providers who use the tool correctly, there was an opportunity to improve the cognitive process associated with risk stratification for VTE prophylaxis and increase the number of patients who receive optimal VTE prophylaxis. This project sought to improve utilization of the VTE tool by providing education on clinical decision support tools, requirement of VTE risk stratification as a core measure performance metric, ACCP recommendations for optimal VTE prophylaxis and session on the correct completion of VTE advisor tool.