SHM Converge Scientific Abstract ePoster Gallery-Hospital-Associated Venous Thromboembolism Prophylaxis Use by Risk Assessment

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This retrospective cohort study at Kaiser Permanente Northern California examined whether an automatically calculated VTE risk score (ePaduaKP) aligned with clinicians’ admission risk assignments and how both related to pharmacologic prophylaxis (pPPX) use in adult medical inpatients from 2013–2019.<br /><br />The study focused on non-surgical, non-ICU hospitalist admissions. ePaduaKP was computed retrospectively from 11 standard VTE risk factors, while clinicians had selected low, moderate, or high risk within the admission order set.<br /><br />Results showed poor agreement between clinician judgment and the automated score. Among encounters labeled “moderate risk” by clinicians, 80.8% were actually low risk by ePaduaKP. pPPX use followed clinician-assigned risk more closely than ePaduaKP: 7.2% of low-risk, 56.7% of moderate-risk, and 69.1% of high-risk clinician-assigned encounters received prophylaxis. In contrast, pPPX use did not track as clearly with ePaduaKP categories; 42.3% of low-risk and 35.6% of high-risk ePaduaKP encounters received pPPX.<br /><br />The findings suggest that admission order set framing may influence clinicians toward choosing “moderate risk,” potentially contributing to prophylaxis overuse. The authors conclude that clinician-assigned risk is overrepresented in the moderate category and that order set design may be shaping both risk perception and pPPX prescribing behavior.

Asset Subtitle

James Xu

Meta Tag

Author List David Schlessinger, Elad Neeman, Heather Clancy, James Xu, Khanh Thai, Laura Myers, Nareg Roubinian, Pranita Mishra, Raymond Liu, Vincent Liu

Category Research

Concept Hospital-Acquired Venous Thromboembolism

Concept Risk Assessment

Concept Pharmacologic Prophylaxis

Concept Clinician-Assigned Risk Category

Concept Venous Thromboembolism Prophylaxis

Distinguished Non-Finalist

Presenter Organization Kaiser Permanente San Francisco Medical Center

Presenting Author James Xu

Track Quality Improvement

Keywords

venous thromboembolism

VTE risk score

pharmacologic prophylaxis

retrospective cohort study

hospitalist admissions

admission order set

clinician risk assessment

ePaduaKP

Kaiser Permanente

prophylaxis overuse

Hospital-Acquired Venous Thromboembolism

Risk Assessment

Pharmacologic Prophylaxis

Clinician-Assigned Risk Category

Venous Thromboembolism Prophylaxis