VTE prevention quality standard

Venous Thromboembolism (VTE) is an important cause of death in hospitalised patients, and treatment of non-fatal symptomatic VTE and related long-term morbidities is associated with a considerable cost to the health service. In 2004-05, there were around 64,000 finished consultant episodes (that is, periods of care under a consultant within an NHS trust) with a diagnosis of VTE. In 2005, VTE was registered as the underlying cause of death in more than 6500 patients, although this figure is likely to be an underestimate of the true incidence. The risk of developing VTE depends on the condition and/or procedure for which the patient is admitted and on any predisposing risk factors (such as age, obesity and concomitant conditions). This quality standard provides clinicians, managers and service users with a description of what a high-quality VTE prevention service should look like.

The reduction in risk of VTE in adults admitted as hospital inpatients or formally admitted to a hospital bed for day-case procedures.

Pregnant women and women up to 6 weeks post partum who are admitted to hospital are also specifically covered by this quality standard. The prevention of VTE in pregnant women in primary and community settings is covered by the relevant Royal College of Obstetricians and Gynaecologists guidance (‘Thrombosis and embolism during pregnancy and the puerperium, reducing the risk' [Green-top guidance 37], 2009).

The quality standard for VTE prevention applies to part of the care pathway for the prevention and management of VTE. Services across the care pathway should be commissioned from and coordinated across all relevant agencies. An integrated approach to provision of services is fundamental to the delivery of high-quality care to patients for preventing and managing VTE.

• VTE Prevention areas of care map: click here to see the quality statements mapped against the areas of VTE Prevention

• Department of Health 'Venous thromboembolism prevention: a patient safety priority' (2009).

National Institute for Health and Clinical Excellence (NICE) clinical guideline 92 (CG92), 'Venous thromboembolism - reducing the risk of venous thromboembolism (deep vein thrombosis and pulmonary embolism) in patients admitted to hospital' (2010; NHS Evidence accredited), and NICE clinical guideline 46 (CG46), 'Venous thromboembolism: reducing the risk of venous thromboembolism (deep vein thrombosis and pulmonary embolism) within in-patients undergoing surgery' (2007; NHS Evidence accredited). CG46 focuses on the management of surgical patients and is both incorporated and partially updated by CG92. The timelines for development of this Quality Standard were adjusted due to changes in the development schedule of CG92.

Department of Health, ‘Risk assessment for venous thromboembolism' (updated March 2010 to comply with CG92).

Director

Val Moore

Consultation and field testing of the VTE Prevention quality standard took place from 12 January until 9 February 2010. In total, 237 stakeholders were contacted during consultation and the NICE field team visited four provider organisations to discuss the draft standard in detail. All eligible comments were reviewed by the Topic Expert Group and Quality Standards Programme Board and the standard was updated accordingly.

• VTE Prevention field testing and consultation report

Many organisations share NICE's commitment to improve quality by making it clear what quality care is for patients and the public, health and social care professionals, commissioners and service providers.

So that these standards reach the widest possible audience, some of the organisations who have been involved in the development process, and who endorse the VTE Prevention quality standard, have become partners in its publication.