Project Summary

PCORI implementation projects promote the use of findings from PCORI-funded studies in real-world healthcare and other settings. These projects build toward broad use of evidence to inform healthcare decisions.

This PCORI-funded implementation project is putting a blood clot prevention program, shown to reduce missed and declined doses of medicine, into standard practice at trauma centers across the country.

Each year, an estimated 12 million patients are at risk for blood clots while they are in the hospital. Patients with serious injuries are at particularly high risk for blood clots.

Implementation Project Summary

What is the goal of this implementation project?

Venous thromboembolism, or VTE, occurs when blood clots form inside veins. VTE may cause serious health problems or even death. Medicine can help prevent VTE; but missing even one dose can lead to blood clots. A PCORI-funded research study tested a nurse and patient education program to prevent blood clots in patients in the hospital. The program helped reduce the number of missed or declined doses of medicine. In addition, in a completed PCORI-funded implementation project, two hospitals successfully used this program as part of regular care.

This project will expand the program to a network of trauma centers to help lower the risk of blood clots among patients at high risk for VTE. Trauma centers are hospitals that specialize in providing care to patients who have a serious injury. 

What will this project do?

The project team is putting the blood clot prevention program in place at 10 trauma centers across the country. The team is working with the centers to:

  • Provide online training to nurses about how to support discussions with patients about preventing blood clots. The training will also teach nurses how to use patient education materials such as handouts and videos.
  • Adjust systems that use data the centers already collect to identify patients who miss taking their medicine.
  • Modify electronic health record (EHR) systems so that nurses receive an alert in real time when patients miss a dose.
  • Support nursing staff as they roll out the program. Work with nurse champions who encourage others to use the alert system at each center.

The project team is working with trauma center administrators to tailor the program for each center.

What is the expected impact of this project?

This project is adapting this program and demonstrating its use in diverse trauma centers. It will lay the groundwork for broad scale-up of the program in trauma centers across the United States.

In this project, more than 3,500 nurses and 30,000 patients at high risk for VTE will receive the program. The project evaluation will confirm that the program is working as intended to reduce the risk of blood clots.

More about this implementation project:

Stakeholders Involved in This Project

  • North American Thrombosis Forum
  • National Blood Clot Alliance
  • Patient Safety Movement Foundation
  • Consortium of Leaders in the Study of Traumatic Thromboembolism (CLOTT) Network
  • American College of Surgeons Committee on Trauma
  • Society of Trauma Nurses
  • The Eastern Association for the Surgery of Trauma
  • American Association for the Surgery of Trauma
  • American Trauma Society
  • Coalition for National Trauma Research 

Implementation Strategies

  • Promote shared decision making.
  • Use a clinical decision support tool.
  • Adapt the program to work with sites’ existing resources and workflows.
  • Integrate a real-time alert system into the electronic health record.
  • Provide sites with tools to support implementation.
  • Provide educational materials for patients, as handout and video.
  • Use online nursing education modules.
  • Create a learning collaborative to support use of the program at sites.
  • Identify and prepare champions at sites, including nurses, physicians, and pharmacists.
  • Conduct site visits.
  • Provide technical assistance to sites, including practice facilitation and consultation.
  • Partner with national stakeholder organization to develop plans for further program scaleup.

Evaluation Outcomes

To document implementation:

  • Number of patients receiving the program
  • Number of nurses trained to deliver the program
  • Additional measures of acceptability, fidelity of program delivery, and sustainability
  • Implementation barriers and facilitators

To assess healthcare and health outcomes:

  • Among eligible patients, number of missed doses of VTE prevention medicine, including number of doses missed due to patient refusal
  • Number of VTE events

Project Information

Elliott Haut, MD, PhD
Coalition for National Trauma Research
$1,392,003

Key Dates

June 2020
February 2023
2020

Initial PCORI-Funded Research Study

This implementation project focuses on putting findings into practice from this completed PCORI-funded research study: Can Nurse and Patient Education Reduce Missed Doses of Medications to Prevent Blood Clots in Hospitals?

Related PCORI Dissemination and Implementation Project

This implementation project is related to another PCORI-funded Dissemination and Implementation project, which is now complete: Adapting a Blood Clot Prevention Program for Routine Use in Hospitals

Tags

State State The state where the project originates, or where the primary institution or organization is located. View Glossary
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Last updated: May 9, 2022