Improving the quality of care for patients at risk for venous thromboembolism.
OBJECTIVE
To describe risk factors for venous thromboembolism (VTE), quality improvement efforts for VTE prevention, and strategies health-system pharmacists can use to improve anticoagulant use and outcomes in patients at risk for VTE.


CONCLUSIONS
Risk factors for VTE involve the presence of one or more components of Virchow's triad (endothelial injury, circulatory stasis, and hypercoagulable states) and are exceedingly common in hospitalized patients. Several effective methods for VTE prophylaxis are readily available but remain underused. Quality improvement initiatives to improve VTE prophylaxis rates include evidence-based clinical practice guidelines, mandatory practice and outcomes reporting, and pay-for-performance requirements. The development and implementation of VTE risk assessment tools and treatment algorithms, protocols, policies, and procedures are among the strategies that health-system pharmacists can use to improve anticoagulant use and quality of care in patients at risk for VTE.


CONCLUSIONS
The use of anticoagulant therapy presents health-system pharmacists with both challenges and opportunities to improve the quality of care in patients at risk for VTE.
Haines
Stuart T
ST
University of Maryland School of Pharmacy, Baltimore, MD, USA. shaines@rx.maryland.edu
D003695:Delivery of Health Care / Q000639:trends; D006801:Humans; D011787:Quality of Health Care; D018570:Risk Assessment; D012307:Risk Factors; D054556:Venous Thromboembolism / Q000453:epidemiology* / Q000517:prevention & control*