DVT Prevention Push
Hopkins escalates efforts to deter a silent killer: deep vein thrombosis.

“THIS IS A CALL TO ACTION … I COMMEND HOPKINS FOR BEING A KEY PARTNER IN THIS EFFORT TO TEACH OTHERS HOW TO APPLY BEST PRACTICES TOWARD PREVENTION.” — ACTING U.S. SURGEON GENERAL REAR ADMIRAL STEVEN GALSON

Last month’s inaugural deep venous thrombosis symposium took on greater import, thanks to a late-notice appearance by the acting U.S. Surgeon General, Rear Admiral Steven K. Galson.

In his opening remarks to a group of about 180 physicians, nurses and other health care professionals in Hurd Hall, Galson urged more vigilance to thwart deep vein thrombosis and pulmonary embolism. “My job is to help create cultural awareness about health and to reduce Americans’ illness,” he said. “This is a call to action to prevent DVT and PE, which are not suspected much of the time. I commend Hopkins for being a key partner in this effort to teach others how to apply best practices toward prevention.”

Deep venous thrombosis—blood clots in the legs—affects more than 900,000 Americans every year and causes almost 300,000 deaths annually, according to the National Alliance for Thrombosis and Thrombophilia. That figure is greater than the combined number of people who die each year from AIDS, breast cancer and automobile accidents.
When a clot forms in a large vein, it can prove deadly if it travels to the lungs. At that point the clot morphs into a pulmonary embolism. Symptoms can easily go unnoticed until it’s too late, as was the case for NBC correspondent David Bloom, who died suddenly in 2003 while on assignment in Iraq.

For its part, over the past several years, Hopkins Hospital has ramped up DVT precautions and staff compliance with protocols. This is particularly critical considering the roughly 35,000 surgeries performed at the hospital annually. “Hopkins is a complicated place,” said Beryl Rosenstein, the hospital’s vice president for medical affairs, at the symposium, “but we’ve all come together—nursing, medicine, pharmacy, the Center for Innovation, administration—for this exercise, and we’re making great strides to track problems and progress.”

The four-hour DVT symposium heralds a formal opportunity to exchange the
latest developments, says Deborah Hobson, patient safety clinical specialist at the Center for Innovation in Quality Care. Hobson, aided by hematologist Michael Streiff, has spearheaded the DVT Collaborative since 2005, when Hopkins was only at 26 percent compliance with DVT prevention practices at patient discharge. Two years later, that number rose to 68 percent, thanks to required documentation. Today, computerized provider order entry tells the story: “Though more vigilance is needed, we now know that 94 percent of patients admitted to the hospital have been assessed for DVT,” says Hobson.

In addition, the hospital has taken a place on the DVT national stage, working steadily with the Center on Medicare Services and the government to adopt a model. “Until recently there was no system in place to monitor potential DVT patients,” says Peter Pronovost, co-chair of the hospital’s Patient Safety Committee. “We’re leading in a robust way and applying Joint Commission requirements with the same rigor that makes Hopkins great.”

–Judy F. Minkove