Barriers and facilitators to implementation of hospital-wide venous thromboembolism risk assessment models: A scoping review

Venous thromboembolism (VTE), which encompasses deep venous thrombosis (DVT) and pulmonary embolism (PE), is a common preventable complication in hospitalized patients. Risk assessment tools allow for easy stratification of patient VTE risk and have been demonstrated to reduce incidence of VTE. However, risk assessment tools remain underutilized in clinical practice. This scoping review aims to explore barriers and facilitators to VTE risk assessment usage to improve rates of hospital-acquired VTE and provide recommendations for future implementation strategies. Four databases (PubMed/MEDLINE, Embase, Cumulative Index to Nursing and Allied Health Literature, and Cochrane Database of Systematic Reviews) were searched from January 1990 through December 2025, and 59 studies were included after selection by three independent reviewers. Themes related to ‘decreased provider compliance’ and ‘difficulty of use’ were the most commonly cited barriers. For facilitators, the majority of themes surrounded ‘electronic medical record integration,’ ‘forcing functions,’ and ‘education.’ A prevalence of barriers and a paucity of facilitators contribute to decreased VTE risk assessment usage. Hospital administrators and clinicians should address current barriers and promote facilitators during VTE risk assessment initiatives to maximize patient quality improvement outcomes. ( Prospero ID: CRD42022360033 )