SHM Converge Scientific Abstract ePoster Gallery-Optimizing Admission Order Sets to Reduce Unecessary Venous Thromboembolism Prophylaxis Administration

Pdf Summary

This quality improvement project evaluated whether adding a low venous thromboembolism (VTE) risk option to the hospital admission order set could reduce unnecessary pharmacologic VTE prophylaxis in non-ICU acute care medicine patients. The concern was that hospital quality and safety measures, while intended to prevent VTE, may also encourage overprescribing in patients who are at low risk.<br /><br />The study used a pre-post intervention design in resident-run inpatient hospital medicine teams at an academic center. Low-risk patients were defined as having a Caprini score of 3 and an expected length of stay of 2 days. The pre-intervention period ran from January 1 to June 30, 2024, and the post-intervention period included April 1 to July 1, 2025, and August 1 to October 31, 2025.<br /><br />The intervention aimed to prompt more active VTE risk assessment by making low-risk status a selectable option in the admission workflow. The project sought to determine whether this change improved appropriate prescribing and reduced unnecessary chemoprophylaxis use.<br /><br />The findings suggest that revising admission order sets can reduce inappropriate VTE prophylaxis administration. The authors conclude that electronic health record workflow optimization, specifically requiring clinicians to actively assess VTE risk, may meaningfully improve prescribing practices and support better quality care.<br /><br />Planned next steps include further monitoring of patient safety and prescribing trends, expanding the sample size, including non-academic hospital teams to assess generalizability, and exploring alternative methods for distinguishing low- versus high-risk patients.

Asset Subtitle

August L. Miller

Meta Tag

Author List August L. Miller, Carrie Valenta, Craig Reha, Emilie Langenhan, Emma Sheridan, Sara Kjerengtroen, Sarah Murphy, Spencer Jones

Category Innovations

Concept Venous Thromboembolism Prophylaxis

Concept Low VTE Risk

Concept Decision Support

Concept Admission Order Set

Concept Overprescribing

Distinguished Non-Finalist

Presenter Organization University of Nebraska Medicine

Presenting Author August L. Miller

Track Quality Improvement

Keywords

venous thromboembolism

VTE prophylaxis

hospital admission order set

quality improvement

low-risk patients

Caprini score

electronic health record

prescribing practices

acute care medicine

workflow optimization

Venous Thromboembolism Prophylaxis

Low VTE Risk

Decision Support

Admission Order Set

Overprescribing