Implementing a Quality Intervention to Improve Confidence in Outpatient Venous Thromboembolism Management.
IF 3
Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
引用次数: 0
Abstract
Introduction: Guidelines recommend that patients with acute venous thromboembolism (VTE) represented by low-risk deep vein thrombosis (DVT) and pulmonary embolism (PE) receive initial treatment at home versus at the hospital, but a large percentage of these patients are not managed at home. This study assessed the effectiveness of a quality intervention on provider knowledge and confidence in evaluating outpatient treatment for patients with VTE in the emergency department (ED).
Methods: A pilot program to overcome obstacles to outpatient VTE treatment in appropriate patients was initiated at Baylor Scott & White Health Temple ED. Subsequently, a formalized quality intervention with a targeted educational program was developed and delivered to ED providers. Provider surveys were administered pre- and post-quality intervention in order to assess clinical knowledge, confidence levels, and perceived barriers. Patient discharge information was extracted from electronic health records.
Results: Twenty-five ED providers completed the pre- and post-surveys; 690 and 356 patients with VTE were included in the pre- and post-pilot and pre- and post-quality intervention periods, respectively. Many ED providers reported that a major barrier to discharging patients to outpatient care was the lack of available and adequate patient follow-up appointments. Notably, after the quality intervention, an increase in provider clinical knowledge and confidence scores was observed. Discharge rates for patients with VTE increased from 25.6% to 27.5% after the pilot intervention and increased from 28.5% to 29.9% after the quality intervention, but these differences were not statistically significant. Despite instantaneous uptick in discharge rates after the interventions, there was not a long-lasting effect.
Conclusion: Although the quality intervention led to improvements in provider clinical knowledge and confidence and identified barriers to discharging patients with VTE, discharge rates remained stable, underscoring the need for additional endeavors.
实施质量干预措施，提高门诊患者对静脉血栓栓塞管理的信心。
导言：指南建议以低风险深静脉血栓（DVT）和肺栓塞（PE）为代表的急性静脉血栓栓塞症（VTE）患者在家中接受初步治疗，而不是在医院接受治疗，但这些患者中有很大一部分并未在家中接受治疗。本研究评估了一项质量干预措施对提供者评估急诊科（ED）VTE 患者门诊治疗的知识和信心的效果：方法：Baylor Scott & White Health Temple 急诊科启动了一项试点计划，以克服门诊治疗 VTE 患者的障碍。随后，制定了一项正式的质量干预措施，并向急诊科医疗服务提供者提供了有针对性的教育计划。在质量干预前后对医疗服务提供者进行了调查，以评估临床知识、信心水平和感知障碍。从电子健康记录中提取了患者出院信息：25 名急诊室医疗人员完成了前后调查；试点前后和质量干预前后分别纳入了 690 名和 356 名 VTE 患者。许多急诊室医疗服务提供者表示，将患者转至门诊治疗的一个主要障碍是缺乏可用且充足的患者随访预约。值得注意的是，在质量干预后，医疗服务提供者的临床知识和信心得分都有所提高。试点干预后，VTE 患者的出院率从 25.6% 上升至 27.5%，质量干预后从 28.5% 上升至 29.9%，但这些差异在统计学上并不显著。尽管干预后出院率瞬间上升，但并没有产生持久的效果：结论：尽管优质干预措施提高了医疗服务提供者的临床知识和信心，并发现了VTE患者出院时的障碍，但出院率仍保持稳定，这说明需要做出更多努力。
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来源期刊
Cardiology and Therapy
CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
5.30
自引率
0.00%
发文量
38
审稿时长
6 weeks
期刊介绍：
Aims and Scope
Cardiology and Therapy is an international, open access, peer reviewed (single-blind), rapid-publication journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of cardiovascular therapies and interventions, including devices. Studies relating to diagnosis and diagnostics, pharmacoeconomics, public health, quality of life, as well as patient care, management and education are also encouraged.
Areas of focus include, but are not limited to, ischaemic heart disease and acute cardiac care, myocardial, valvular, pericardial and congenital heart disease, vascular and pulmonary disease (including hypertension), arrhythmias, heart failure, non-invasive diagnostic techniques, and invasive and interventional cardiology as well as cardiovascular surgery.
The journal is of interest to a broad audience of pharmaceutical and healthcare professionals and publishes original research, reviews, case reports/case series, trial protocols and short communications such as commentaries and editorials. Cardiolology and Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of quality research, which may be considered of insufficient interest by other journals.
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The journal’s publication timelines aim for a rapid peer review of 2 weeks. If an article is accepted it will be published 3–4 weeks from acceptance. The rapid timelines are achieved through the combination of a dedicated in-house editorial team, who manage article workflow, and an extensive Editorial and Advisory Board who assist with peer review. This allows the journal to support the rapid dissemination of research, whilst still providing robust peer review. Combined with the journal’s open access model this allows for the rapid, efficient communication of the latest research and reviews, fostering the advancement of cardiovascular therapies.
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Upon acceptance of your article for publication, authors will be required to pay the mandatory Rapid Service Fee of £3650/€4500/$5100. The journal will consider fee discounts for developing countries and this is decided on a case by case basis.
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