Preventing Unintended Consequences of Quality Measurement for Venous Thromboembolism Prophylaxis
Authors: David W. Baker, Amir Qaseem
Journal: Annals of Internal Medicine (2012)

Letters21 February 2012Preventing Unintended Consequences of Quality Measurement for Venous Thromboembolism ProphylaxisDavid W. Baker, MD, MPH and Amir Qaseem, MD, PhD, MHADavid W. Baker, MD, MPHFrom Feinberg School of Medicine at Northwestern University, Chicago, IL 60611, and American College of Physicians, Philadelphia, PA 19106.Search for more papers by this author and Amir Qaseem, MD, PhD, MHAFrom Feinberg School of Medicine at Northwestern University, Chicago, IL 60611, and American College of Physicians, Philadelphia, PA 19106.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-156-4-201202210-00025 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Drs. Bratzler and Loeb and Ms. Krusevioski argue that the current Joint Commission's VTE prophylaxis measure is acceptable because it allows for clinicians to document exceptions. However, as we all agree, there are no established prediction rules to identify patients who do not benefit from VTE prophylaxis, and there are no guidelines from national experts on who should be considered low-risk. It therefore seems imprudent to rely on every hospital to develop its own “risk assessment form” to identify patients for whom VTE prophylaxis is not indicated. A better alternative would be to use a more restricted measure ...References1. Geerts WH, Bergqvist D, Pineo GF, Heit JA, Samama CM, Lassen MR, et al; American College of Chest Physicians. Prevention of venous thromboembolism: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest. 2008;133:381S-453S. [PMID: 18574271] CrossrefMedlineGoogle Scholar2. Qaseem A, Chou R, Humphrey LL, Starkey M, Shekelle P; Clinical Guidelines Committee of the American College of Physicians. Venous thromboembolism prophylaxis in hospitalized patients: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2011;155:625-32. [PMID: 22041951] LinkGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Feinberg School of Medicine at Northwestern University, Chicago, IL 60611, and American College of Physicians, Philadelphia, PA 19106.Disclosures: Dr. Qaseem was an author of the American College of Physicians' guideline on VTE prophylaxis (2). Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M11-2065. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoEvidence-Based Performance Measures: Preventing Unintended Consequences of Quality Measurement David W. Baker , Amir Qaseem , and Venous Thromboembolism Prophylaxis in Hospitalized Patients: A Clinical Practice Guideline From the American College of Physicians Amir Qaseem , Roger Chou , Linda L. Humphrey , Melissa Starkey , Paul Shekelle , and Preventing Unintended Consequences of Quality Measurement for Venous Thromboembolism Prophylaxis Dale W. Bratzler , Jerod M. Loeb , and Denise Krusenoski Preventing Unintended Consequences of Quality Measurement for Venous Thromboembolism Prophylaxis Azeem Majeed Metrics 21 February 2012Volume 156, Issue 4Page: 328KeywordsHeart failureHemoglobinInflammatory bowel diseaseMedical risk factorsProphylaxisPulmonary diseasesRisk assessmentsSepsisTreatment guidelinesVenous thromboembolism ePublished: 21 February 2012 Issue Published: 21 February 2012 Copyright & PermissionsCopyright © 2012 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...