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Management of suspected venous thromboembolism: the impact of a multifaceted intervention.

Abstract : OBJECTIVE: To achieve a common strategy in the event of a suspected venous thromboembolism. DESIGN: A multifaceted intervention, combining an audit strategy and implementation of local guidelines: phase 1, the first step, consisted of a 6-month audit to identify dysfunction; during phase 2, intervention, local guidelines were formulated by a working group and then implemented; phase 3 consisted of a re-audit over a 6-month period following the intervention. SETTING: A tertiary hospital, France. PARTICIPANTS: 419 patients with suspected venous thromboembolism in phase 1; 287 patients with suspected pulmonary embolism in phase 3. RESULTS: First phase: a dysfunction was observed in three of five criteria under study: (i) the diagnostic procedure lasted more than 48 hours in 114 patients (27.2%); (ii) no anticoagulant therapy at the time of suspicion in 116 patients (27.7%); (iii) an inconclusive lung scan without further testing in the event of a suspected pulmonary embolism in 40 patients (14%); the intervention phase was thus restricted to the management of suspected pulmonary embolism; similar results were found during the phase 3 re-audit. CONCLUSION: No improvement in the diagnostic work-up in the event of a suspected pulmonary embolism was observed following this multifaceted intervention.
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https://hal.univ-brest.fr/hal-00759333
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Submitted on : Friday, November 30, 2012 - 2:34:37 PM
Last modification on : Thursday, November 29, 2018 - 4:09:24 PM

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Pierre-Yves Salaun, Francis Couturaud, Karine Lacut, Michel Nonent, Christophe Gut-Gobert, et al.. Management of suspected venous thromboembolism: the impact of a multifaceted intervention.. International Journal for Quality in Health Care, Oxford University Press (OUP), 2005, 17 (5), pp.433-8. ⟨10.1093/intqhc/mzi050⟩. ⟨hal-00759333⟩

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