Detroit Receiving Hospital is a 320 bed hospital located in Detroit, Michigan. Our hospital joined the HMS collaborative in 2012. Our HMS team includes Dr. Renato Roxas as physician champion, Brenda Lawrence as quality manager, and Alexander Vaught as the clinical data abstractor. Debbie Dusik-Brinkman, Director of clinical transformation, and Wanda Vesey, Regional Director of Abstraction with corporate quality and safety are also involved with the HMS-related work. We have implemented the following quality improvement intiatives related to HMS to improve the quality of care for hospitalized medical patients.
EMR changes occurred in July 2014 to improve the adequacy of completing VTE risk assesment
- VTE Risk Level and Score is included Results Review in I-view under the VTE Prevention section.
- ED providers were able to receive VTE alert four hours after the Admit to Obs or Admit to Inpatient order is placed.
- VTE Assessment tool in the EMR was updated to include documentation of "VTE on Admission" and the ability to order SCD's when pharmacologic prophylaxis is contraindicated.
- Modification made in security position assigned to physicians and educating physicians of importance of choosing an appropriate relationship to receive the VTE risk assesment alert.
- Notification alert are sent to physicians when patient refuses pharmacological prophylaxis.
- VTE intial assessment tool was available to order before the 4 hours of alert after admission.
- Educational efforts -
- Increasing awareness to the physicians to accurately add all the problems and diagnosis before completing the risk assessment tool for the accuracy of the risk assessment score.
- The widget DMC perfect care (http://dmcperfectcare.org/) housing important core measures including VTE educational info in one location became available to physicians.
- Development of Net Learning module for using the ‘widget’- Perfect Care by VTE and Resident Engagement Program