Background: Venous thromboembolism (VTE) prophylaxis is a critical component of inpatient care, butinappropriate or unnecessary pharmacologic administration can expose patients to avoidablerisks, such as bleeding, and increase healthcare costs. At our institution, there has been shownto be an unnecessary amount of prophylaxis used on patients that don’t meet criteria forneeding VTE prophylaxis. For low-risk non-ICU patients, it can be difficult to identify a safeoption to defer starting prophylaxis.
Purpose: To evaluate whether implementing an alternative admission order set for low-risk non-ICU levelpatients can reduce unnecessary pharmacologic prophylaxis while maintaining patient safety.
Description: This quality improvement initiative utilized a pre–post intervention design. It was targeted to theacademic resident-run hospital medicine teams. Baseline data was collected over a 6-monthperiod on VTE prophylaxis prescribing patterns, focusing on patients who did not meetguideline-based criteria for pharmacologic prophylaxis (Caprini Score). A revised admissionorder set was developed and added to admission orders for VTE medication selection.Post-implementation data was analyzed for changes in the rate of inappropriate VTEprophylaxis orders, bleeding events, and incidence of hospital-acquired VTE.
Conclusions: Preliminary findings indicate a significant reduction in inappropriate VTE medication orderswithout an increase in VTE events. Ongoing monitoring aims to ensure safety and sustainabilityof the intervention. Revising admission order sets to require active VTE risk evaluation canmeaningfully reduce unnecessary pharmacologic prophylaxis. This intervention supports safer,evidence-based prescribing practices and demonstrates the value of optimizing electronichealth record workflows for quality improvement.