Abstract
OBJECTIVE: To measure the effect of a computerized reminder system on the rate of deep vein thrombosis (DVT) prophylaxis in surgical patients. DESIGN: A prospective trial to measure change in compliance compared to historic controls. MEASUREMENTS: LDS Hospital surgeons developed local consensus as to which procedures should have DVT prophylaxis. The historic rate of prophylaxis for the procedures was measured through a database search of patient records. A computerized reminder system was then implemented which utilized an expert knowledge base and a time drive mechanism to flag surgical cases for DVT prophylaxis. For eligible patients, a DVT reminder appeared on the operating room schedule; surgical staff used this as a guide to apply prophylaxis. During the 3 month trial the rate of DVT prophylaxis was remeasured and compared to the pre-intervention rate. RESULTS: The pre-intervention rate of DVT prophylaxis over a 3 month period was 85.2% (785 of 921 eligible cases). For the 3 months following the introduction of the computerized reminder, compliance with DVT prophylaxis increased to 99.3% (1084 of 1092 eligible cases). The difference between the historic controls and the study subjects was highly significant (p < 0.001). CONCLUSION: A computerized reminder is an effective method of increasing the rate of DVT prophylaxis in surgical patients.
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Selected References
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