Thrombocalc: personalized postpartum venous thromboembolism risk assessment in a high-throughput environment

Background: Obstetric venous thromboembolism is or VTE is a leading cause of maternal mortality in the developed world causing over 14% of deaths according to the WHO (Lancet 2006). Better recognition of at-risk women and... [ view full abstract ]

Background:
Obstetric venous thromboembolism is or VTE is a leading cause of maternal mortality in the developed world causing over 14% of deaths according to the WHO (Lancet 2006). Better recognition of at-risk women and widespread targeted thromboprophylaxis are key in reducing morbidity and mortality related to VTE. Four fifths of the women who died from VTE between 2011 and 2013 had recognisable risk factors for thromboembolism, thus highlighting the need to improve recognition of the woman at risk to correctly target women who would benefit most from thromboprophylaxis.

Aims/Objectives:
To develop and implement a bedside user friendly risk assessment tool in the immediate post natal period to ensure appropriate and timely thromboprophylaxis

Methodology
A multidisciplinary team approach was utilised to develop and implement a risk assessment tool to assist the identification of those patients requiring early thromboprophylaxis. There were two phases in the roll out of the tool: Initial technical validation and user acceptability. Integrated prescribing recommendations to streamline and standardise VTE risk assessment process.

Outcome /Results:
Since the introduction of the risk assessment tool there has been a significant increase in documented risk assessment of patients. The use of the Thrombocalc tool consistently provides a standarised approach to VTE risk assessment

Conclusions and Implications:
The initial pilot phase of this project is now complete, whereby an electronic assessment tool is available, which calculates and assigns the patient to a VTE risk category and informs the multidisciplinary staff members of the amount of thromboprophylaxis required for the patient. Currently ongoing work is being conducted to ensure clinical validation. Following the completion of this validation process, plans for the future include the spread of this initiative to other maternity units nationally.