SHM Takes on VTE

The Hospitalist. 2008 March;2008(03):

March 1, 2008|The Hospitalist

Venous thromboembolic (VTE) disease, ranging from asymptomatic deep-vein thrombosis (DVT) to massive pulmonary embolism (PE), is a significant cause of morbidity and mortality in hospitalized patients. Almost all hospitalized patients are at risk for VTE, and the literature suggests approximately half of all VTEs are hospital-acquired.

Hospitalists are ideally positioned to reduce the incidence of preventable VTEs, both by using known best practices to improve care delivered to their own patients, and, more importantly, by leading hospitalwide efforts that improve care for all patients at their home institutions.

In recognition of this important clinical issue and the role hospitalists can play in addressing it, SHM launched the VTE Prevention Collaborative (VTEPC) in January 2007. The program offers individualized assistance to hospitalists wishing to take the lead in this area.

The VTEPC offers two technical assistance options. Individuals interested in securing ongoing support for their planned or active VTE prevention projects can enroll in the mentoring program. This allows a full year of access to and support from SHM mentors with VTE and quality-improvement (QI) expertise. Mentoring occurs in eight telephone calls, during which mentors offer individualized assistance on any topics, tasks, or barriers commonly encountered in designing, implementing, and evaluating a VTE prevention project.

Hospital Medicine Fast Facts

Improve Career Satisfaction

SHM’s “A Challenge for a New Specialty: A White Paper On Hospitalist Career Satisfaction” identifies four pillars of hospitalist career satisfaction:

Reward/Recognition: The need for appropriate reward—monetary and nonmonetary—for a job well done;
Workload/Schedule: The need for a manageable workload and a sustainable schedule;
Autonomy/Control: The need to be able to influence the key factors that affect job performance; and
Community/ Environment: The need for a community and environment that supports a satisfying, engaged career.

For each pillar, the white paper outlines five strategies that can yield results:

Get the facts: Information that can be researched, analyses that can be conducted, and/or surveys that might be administered;
Plan organizational/ structural strategies: Formal steps that can be taken with regard to the structure of the hospitalist group, how it is staffed, and/or how hospitalists are compensated;
Organize systems strategies: Changes that can be made to the operation (processes) of the hospitalist group;
Prepare professional development strategies: Actions that can be taken directed at individual hospitalists; and
Formulate marketing/relationship strategies: Ways hospitalists can relate to other key stakeholders in heir work environment. TH

Download a copy of “A Challenge for a New Specialty: A White Paper On Hospitalist Career Satisfaction,” visit the “Publications” section on www.hospital medicine.org.

Read about each pillar in the “Career Development” section of the June through September 2007 issues of The Hospitalist.

An on-site consultation program is designed for individuals interested in securing expert evaluation and input on a VTE prevention program but who don’t feel they need ongoing, longitudinal support. In this program, SHM consultants with VTE and QI expertise visit applicants’ hospitals to evaluate active or planned VTE prevention programs. The consultation visits feature a structured evaluation of the site’s strengths and resources, barriers to improvement, and the design and function of active or proposed VTE prevention interventions.

For both programs, support and instruction are organized around the VTE QI workbook, “Preventing Hospital-Acquired Venous Thromboembolism: A Guide for Effective Quality Improvement,” SHM’s step-by-step guide for developing a VTE prevention program. SHM secured the services of Greg Maynard, MD, and Jason Stein, MD, to provide mentoring and conduct consultation visits. Drs. Maynard and Stein have led successful local VTE prevention QI projects, hold QI leadership positions, and have taught QI and VTE prevention principals to local and national audiences. Dr. Maynard is head of the Division of Hospital Medicine and associate clinical professor of medicine at the University of California, San Diego. Dr. Stein is a hospitalist at Atlanta’s Emory University Hospital, assistant professor of medicine at Emory University School of Medicine, and director of quality improvement for the Emory Hospital Medicine Unit.