Risk Update: DVT Risk, Elite & Pro Athletes, NEW Resources
“National Blood Clot Alliance (NBCA) reports, it is estimated that 3% of orthopaedic surgical patients will develop a deep vein thrombosis (DVT), and 1.5% will develop at pulmonary embolism.”
Clots remain a common cause of readmission and death following joint replacement surgeries. As a known risk, the incidence of blood clot is often discussed in pre-operative and informed consent discussions. DVT risk assessments are also standard practice in the care and treatment of patients undergoing orthopaedic procedures. While risk assessments are standard, at times processes that can impact care may vary.
An NBCA survey found, “Therapeutic barriers perceived by total hip arthroplasty (THA) and total knee arthroplasty (TKA) surgeons impact their use of anticoagulation therapies in the prevention of deep vein thrombosis (DVT) and pulmonary embolism (PE) among THA/TKA patients, and, despite evidence-based guidelines, DVT/PE prophylaxis practices vary widely…”
Below are some considerations for process improvement and standardization to reduce gaps that may pertain to variability:
Hand-Offs of Care Continual risk assessment during IP, rehab or home care (including ability to ambulate at home) Communicate any change in care plan or DVT prophylactics to ordering physician/provider
Medication Reconciliation Ensure discharge and current medications match intended plan
Follow Up Confirm patient is utilizing recommended prophylactic measures Documented informed refusal conversation if noncompliance Assess risk for DVT at post-operative follow up visits Health or ambulatory changes could change plan Consider assessing risk and compliance with prophylactic measures via post-operative calls (via care navigators)
Patient/Family Education In addition to procedural education, informed consent and discharge instructions, consider providing patient with information pertaining to risk of blood clots (i.e. Stop The Clot)
Quality Improvement Review risk assessments utilized among providers and APPs to determine consensus Review documentation of risk assessments, plan, reassessment and compliance for thoroughness to support decisions/care plan Peer review of all post-operative diagnoses of DVT or PE for opportunities for improvement, education and process change
Elite & Professional Athlete Coverage & Liability: A discussion with The OrthoForum, MAGMutual, and Ortho Risk Partners
Massive economic damages in malpractice settlements are no longer isolated to the professional athlete. With name, image and likeness (NIL) deals, elite and college athletes now have earning power commensurate with professional athletes. This larger pool of high earners with potential for career limiting and ending injuries must be considered when evaluating medical malpractice limits and mitigating risks for providers and organizations that care for or direct the medical care of these athletes and their teams. This program will provide practices and providers caring for elite and professional athletes’ considerations to reduce risk related to contracts, coverage and marketing.
New Resources Aim at Raising Awareness Along the Healthcare Risk Continuum
MAGMutual, your medical malpractice insurer, has recently released a number of programs aiming to reduce a number of operational risks within the practice. Links to these resources are provided below.
