title: 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.
  
  
  METHODS
  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.
  
  
  METHODS
  A tertiary hospital, France.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  No improvement in the diagnostic work-up in the event of a suspected pulmonary embolism was observed following this multifaceted intervention.
authors.affiliation: Groupe d'Etude de la Thrombose de Bretagne Occidentale (GETBO), Hôpital de la Cavale Blanche, F-29609 Brest Cedex, France.
authors.forename: Pierre-Yves
authors.initials: PY
authors.lastname: Salaun
authors.forename: Francis
authors.initials: F
authors.lastname: Couturaud
authors.forename: Karine
authors.initials: K
authors.lastname: Lacut
authors.forename: Michel
authors.initials: M
authors.lastname: Nonent
authors.forename: Christophe
authors.initials: C
authors.lastname: Gut-Gobert
authors.forename: Gregoire
authors.initials: G
authors.lastname: Le Gal
authors.forename: Philippe
authors.initials: P
authors.lastname: Guillo
authors.forename: Jean
authors.initials: J
authors.lastname: Jouquan
authors.forename: Dominique
authors.initials: D
authors.lastname: Mottier
authors.forename: Christophe
authors.initials: C
authors.lastname: Leroyer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000517:prevention & control*; D011785:Quality Assurance, Health Care; D020246:Venous Thrombosis / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*