SHM Converge Scientific Abstract ePoster Gallery-Impact of Centralized Messaging Notification on Venous Thromboembolism Prophylaxis Refusals

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This study examined whether notifying primary inpatient providers about venous thromboembolism (VTE) prophylaxis refusals through Microsoft Teams could reduce refusal rates on general medical wards. VTE is a major preventable cause of in-hospital death, and refusal of pharmacologic prophylaxis is a common reason doses are not administered.<br /><br />Using a prospective pre/post design at MedStar Georgetown University Hospital, the team reviewed adult medicine inpatients and observation patients prescribed heparin or enoxaparin over 12 weeks: 6 weeks before and 6 weeks after the intervention. Refusals were identified from the electronic medication administration record, and daily refusal rates were analyzed with interrupted time series methods.<br /><br />A total of 1,006 admissions were included. Before the intervention, the average daily refusal rate was 6.5% and was increasing by 0.1% per day, a statistically significant upward trend. After providers began receiving centralized refusal notifications at 7:00 am or 1:00 pm on weekdays, the daily trend shifted to a decrease of 0.16% per day, also statistically significant. This suggests the intervention reversed the prior worsening refusal pattern.<br /><br />The authors note that some patients were “chronic refusers,” which may limit the effect size. They also suggest future studies in other hospitals and over longer periods to test generalizability and durability.<br /><br />Overall, the study concludes that centralized direct messaging to providers reduced VTE prophylaxis refusal rates and may offer a lower-cost alternative to in-person educator programs by leveraging the provider-patient relationship.

Asset Subtitle

Eric Reid

Meta Tag

Author List Alex Montero, Elias Z. Eldadah, Eric Reid, Khader Abdi, Lauren Lubrano

Category Research

Concept Venous Thromboembolism Prophylaxis

Concept Venous Thromboembolism

Concept Chemoprophylaxis

Concept Patient Refusal

Concept Inpatient Mortality

Distinguished Non-Finalist

Presenter Organization Medstar Georgetown University Hospital

Presenting Author Eric Reid

Track Quality Improvement

Keywords

venous thromboembolism

VTE prophylaxis

medication refusal

inpatient care

general medical wards

Microsoft Teams

provider notification

heparin

enoxaparin

interrupted time series

Venous Thromboembolism Prophylaxis

Venous Thromboembolism

Chemoprophylaxis

Patient Refusal

Inpatient Mortality