The EBM Information Quest: Is it true? Is it useful? Is it usable?™
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Venous Thromboembolism Guideline Materials are posted with permission from Kaiser Permanente Hawaii and Delfini Group. Selected components of guideline documentation are available from Delfini upon request.
Kaiser Permanente Hawaii (KPHI): Prevention of Venous Thromboemobolism (VTE) in Total Hip and Total Knee Replacement
Mission: Help advance evidence- and value-based medicine in an organization that has already proved a demonstrated commitment to evidence- and value-based care by dedicating resources to EBM training and support and that now seeks to progress to an even higher level in skill, depth, application and cultural transformation.
Concept: Identify a clinical group that has ideas for a successful evidence-based clinical improvement project and provide them with training and support. Learnings will be applicable to other projects, plus team members will be able to facilitate similar projects with other clinical groups within the care system.
Delfini Role: Provide training, facilitation and support to the team to conduct the project and to effect both clinical and evidence-based process change.
At VTE Project
Quick Navigator to Selected Resources
|Venous Thromboembolism (VTE) Prevention Update, Clinical Practice Guideline & Decision Support|
Update: What’s New In Venous Thromboembolism (VTE) Prophylaxis For Total Hip and Total Knee Replacement Surgery 2009
In the summer of 2008, a group of KPHI clinicians and other stakeholders (orthopedists, hospitalists, pharmacists, nurses, facilitators, CME and EBM specialists) formed a working group—the KPHI VTE Prevention Guideline Team—along with Delfini to address the significant uncertainty about the following key questions:
What We Learned and Recommend To Others
Details regarding specific mechanical devices, drugs, bleeding risks, the quality of the evidence, dosing, etc. are available immediately below.
Read the interview with medical leader, Karen Ching MD, about how to make such evidence-based quality improvement projects successful
Phase I: Identify Team
Phase II: Select Project
III: Develop Project Outline
Phase IV: Obtain, Evaluate & Synthesize Evidence & Phase V: Create Clinical Recommendations
Potentially useful evidence was obtained through a systematic search and filtering process using titles and abstracts. Following filtering, the potentially best available valid and useful evidence was identified and readied for critical appraisal.
Team members received training in effective searching of the medical literature, critical appraisal for validity and clinical usefulness of primary and secondary sources, measures of outcomes, effective use of confidence intervals, evidence grading and more.
of the KPHI VTE Quality Improvement Project & Guideline Team:
In 2 two-day on-site working sessions, team members accomplished the following —
Keys to Success
Phase VI: Assess Impacts of Practice Change
Phase VII: Create information, Decision & Action Aids
Phase VIII: Implement Guideline
Phase IX: Implement Measurement & Reporting Plan
Phase X: Continuous Improvement
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