Two healthcare quality-measurement organizations are forming a tag team to tackle an often-overlooked but serious complication of hospital care and hold providers accountable for preventing the condition.
In the joint project announced last week, the National Quality Forum will oversee development of standardized measures to evaluate performance in reducing the risk for a condition called deep vein thrombosis, or DVT.
The Washington-based consensus-building group for healthcare performance measures will subcontract the creation of a DVT measure set to the Joint Commission on Accreditation of Healthcare Organizations. When the development and testing is finished-the target date is the end of 2005-the NQF will subject the measures to its industry consensus process, with the aim of arriving at nationally recognized standards for DVT prevention and remedial care.
The JCAHO would then make a decision on how to incorporate the new standards into its Oryx program of clinical performance measurement, a component of the accreditation process, said Jerod Loeb, executive vice president of the Oakbrook Terrace, Ill.-based agency.
DVT is a clinical condition in which blood clots form in large veins-usually deep in a leg-partially or fully blocking blood flow. Besides cutting off circulation in a lower limb of the body, a piece of the clot can break off and travel to the lungs, where it can create a potentially lethal blood clot called a pulmonary embolism. Patients admitted to the hospital for other problems are at risk of DVT if they are bed-ridden and sedentary.
Preventive treatments are available, such as administration of a blood thinner called heparin or use of mechanical compression devices to the knee or thigh, but hospitals often do not take those measures for patients considered at risk (May 10, p. 28). Approximately 2 million people suffer from the condition, which leads to 600,000 cases of pulmonary embolism and 200,000 deaths each year, according to industry studies. Those figures are for all settings of care, not just hospitals.
The project is funded by a grant from Aventis, maker of a drug to prevent or treat DVT called low-molecular-weight heparin.
A measure related to vigilance for DVT already is among six measures the JCAHO has isolated to evaluate quality in intensive-care units, Loeb said. ICU care will be added in mid-2005 to the lineup of measure sets among which hospitals must choose to send data to the Oryx clinical program, Loeb said.
It would be the sixth area of clinical measurement required by the JCAHO. In July 2002, the JCAHO began to require accredited hospitals to collect data on two sets of standardized performance measures from a list of four initial sets covering heart attack, congestive heart failure, pneumonia and management of pregnancy. A fifth set on control of surgical infections was added in July, when hospitals were required to choose three from among the five to report.%