Management of suspected venous thromboembolism: the impact of a multifaceted intervention.
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.
Salaun
Pierre-Yves
PY
Groupe d'Etude de la Thrombose de Bretagne Occidentale (GETBO), Hôpital de la Cavale Blanche, F-29609 Brest Cedex, France.
Couturaud
Francis
F
Lacut
Karine
K
Nonent
Michel
M
Gut-Gobert
Christophe
C
Le Gal
Gregoire
G
Guillo
Philippe
P
Jouquan
Jean
J
Mottier
Dominique
D
Leroyer
Christophe
C
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*