Implementing Sustainable Systems for Achieving Excellence in Venous Thromboembolism Prevention

Abstract

Venous thromboembolism (VTE) is a common preventable cause of morbidity and mortality in hospitalized patients. Despite robust guidelines and decades of data there is still underperformance in three important aspects of defect‑free VTE prevention: 1) risk assessment balancing risks of VTE and bleeding, 2) prescription of risk‑appropriate prophylaxis, and 3) reliable administration of all prescribed VTE prophylaxis doses. Preventing hospital associated VTE is not a mystery; it is a test of systems. We propose an accountability framework to attack all three steps, incorporating clinical decision support, clinician feedback and targeted nurse‑ and patient‑centered education to reduce missed doses. Finally, we outline a pragmatic implementation strategy to achieve risk‑appropriate prophylaxis for every patient. To achieve sustained, optimal VTE prevention, institutions must integrate evidence-based protocols, patient engagement, and robust system-level infrastructure, with ongoing surveillance and quality improvement.