Improving adherence to recommended venous thromboembolic prophylaxis in abdominal and pelvic oncologic surgery.

Background: We reviewed rates of adherence to the American College of Chest Physicians guidelines for venous thromboembolism prophylaxis in abdominal and pelvic oncologic surgery at our community hospital compared with rates statewide.

Methods: We completed a retrospective review of adult patients undergoing abdominal or pelvic oncologic surgery from January 1, 2015 to December 31, 2016, compared with statewide data from the Michigan Surgical Quality Collaborative during the same period. Educational intervention included creation of hospital guidelines and presentations reviewing American College of Chest Physicians guidelines and hospital adherence rates. A short-term observation of extended-duration venous thromboembolism prophylaxis rates was completed after the intervention.

Results: The rates of in-hospital venous thromboembolism prophylaxis (general surgery: 93.7%, n = 106; gynecology: 40.0%, n = 32) were comparable to statewide in-hospital prophylaxis rates (89.6% general surgery, 41.8% gynecology). Five patients (4.5%) were prescribed extended-duration prophylaxis, which was lower than statewide rates (20.3%). In comparison, there was a statistically significant improvement in the rate of extended prophylaxis in the 6 months following intervention to 23.6% (n = 5, P < .0005).

Conclusion: The rates of extended-duration venous thromboembolism prophylaxis prescription were lower than the state average at our community hospital; however, the short-term evaluation revealed significant improvement after intervention.