Key result
Standardised outpatient DVT pathway cuts monthly ED visits ~45%.
Why the study?
Patients with DVT frequently present to emergency departments because necessary diagnostic investigations and medical treatment for outpatient management are not readily accessible in outpatient clinics.
Does a standardised outpatient DVT treatment pathway directing patients from the ultrasound department to an expanded thrombosis clinic reduce emergency department visits in patients with newly diagnosed deep vein thrombosis?
Does a standardised outpatient DVT treatment pathway directing patients from the ultrasound department to an expanded thrombosis clinic reduce emergency department visits in patients with newly diagnosed deep vein thrombosis?
Implementing a multidisciplinary outpatient DVT pathway linking ultrasound directly to an expanded thrombosis clinic halved monthly ED visits for DVT and reduced 30-day repeat ED visits from 41.5% to 10.4% without increasing hospital admissions.
Answers are grounded in this paper and cite their sources.
Supports outpatient DVT redirection to reduce ED visits; hypothesis-generating pending randomized confirmation.
Deep vein thrombosis (DVT) is an acute medical condition that requires urgent diagnosis and treatment to prevent significant morbidity and mortality. Patients with DVT frequently present to the emergency department (ED) because the necessary diagnostic investigations and medical treatment for successful outpatient management are not readily accessible in the outpatient clinics. A collaborative quality improvement project was undertaken to implement and evaluate a standardised outpatient treatment pathway designed to direct patients with a newly diagnosed DVT from the ultrasound department to the thrombosis clinic, where guideline-based management for DVT can be accomplished without ED visits. During the baseline period (1 February 2017 to 31 January 2019), the number of ED visits for DVT was 383 with an average of 16 visits per month. During the intervention period (1 February 2019 to 31 January 2020), the number of ED visits for DVT was 106 with an average of 8.8 visits per month. This represents almost a 50% reduction in the average ED visits during the intervention period. A standardised outpatient treatment pathway can significantly reduce the number of ED visits in patients with DVT, potentially improving patient care and reducing ED overcrowding.
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Wan et al. (2021) studied Deep vein thrombosis (DVT). Standardised outpatient DVT treatment pathway directing patients from the ultrasound department to an expanded thrombosis clinic vs. Pre-intervention baseline practice (patients with confirmed DVT on ultrasound directed immediately to the ED for acute treatment) was evaluated on Average monthly number of emergency department (ED) visits for DVT (MD -7.2 visits/month (nearly 50% reduction)). Implementing a standardised outpatient DVT treatment pathway reduced average monthly ED visits for DVT by nearly 50%, from 16 to 8.8 visits per month over 1 year.
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