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Quality improvement report
Improving SCD compliance in trauma patients at Kings County Hospital Center: a quality improvement report
  1. Safraz Hamid1,
  2. Benjamin Gallo Marin2,
  3. Leanna Smith1,
  4. Kwasi Agyeman-Kagya1,
  5. Christopher George1,
  6. Tara Wetzler1,
  7. Abbasali Badami1,
  8. Adam Gendy1,
  9. Valery Roudnitsky1,3
  1. 1Department of Surgery, SUNY Downstate Health Sciences University, Brooklyn, New York, USA
  2. 2Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA
  3. 3Department of Trauma and Acute Care Surgery, Kings County Hospital Center, Brooklyn, NY, USA
  1. Correspondence to Dr. Valery Roudnitsky; valery.roudnitsky{at}nychhc.org

Abstract

Venous thromboembolism (VTE) is the fourth most commonly reported complication in trauma patients. For these patients, thromboprophylaxis is a standard of care. Patient compliance with sequential compression devices (SCDs), a form of mechanical VTE prophylaxis, has been a focus of efforts to improve patient safety. At our institution, a baseline audit in July 2020 revealed that patients admitted to the trauma floors have poor compliance with the use of SCDs. In this quality improvement project, we developed a patient education intervention to improve SCD compliance. We distributed an informational flyer to patients and led short educational sessions on VTE risk factors and proper SCD use. Our aim was to increase our SCD compliance rate by 30% in 4 weeks. We used three plan-do-study-act (PDSA) cycles to implement and refine our intervention. We measured SCD compliance during morning and afternoon patient observations and generated run charts to understand how our cycles were leading to change. After a 4-week period, we did not achieve our aim, but increased our overall compliance from 45% to 60% and sustained this improvement throughout our PDSA cycles. Morning compliance was lower than afternoon compliance both at baseline (45% vs 48.5%) and at the end the project (45% vs 53%). Our results suggest that patient education should be coupled with interventions that address other barriers to SCD compliance.

  • patient education
  • PDSA
  • quality improvement
  • venous thromboembolism
  • surgery
http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjoq-2020-001171

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    Footnotes

    • Twitter @HamidSafraz, @BGalloMarin, @dr_badami

    • Contributors SH, AB and AG conceptualised the intervention; SH led the improvement cycles; SH, LS, KA-K, TW and CG performed data collection; SH, BGM and LS performed data analysis and interpretation; SH and BGM wrote original draft; SH, BGM, LS, TW, CG, AB, AG and VR reviewed and edited draft and VR administered the project.

    • Funding BGM was supported by NIH/NIAID R25AI140490.

    • Competing interests None declared.

    • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

    • Patient consent for publication Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement All data relevant to the study are included in the article.