Title : Optimising VTE prophylaxis in orthopaedic inpatients: A quality improvement approach with HEPMA and AI
Abstract:
Aims: The aim of this quality improvement project was to reduce missed doses of Venous Thrombo Embolism (VTE) prophylaxis in orthopaedic inpatients.
Methods: Conducted from December 2024 to March 2025 on a trauma and orthopaedic ward, baseline data was collected for one month from a retrospective HEPMA report on patients who either didn’t have enoxaparin prescribed, or had it suspended during their inpatient stay. Two key strategies were then implemented:
1.A novel, automated daily HEPMA report identifying patients not prescribed enoxaparin.
2.A redesigned and shared ward handover system on Microsoft Teams.
Post-intervention data was collected over another month from the daily reports. Outcomes measured included the number of patients who had missed or suspended doses, as well as the duration of these missed or suspended doses.
Results: Following intervention, missed doses decreased from 8 patients to 4, with the average days missed reducing from 6.4 to 3.0. Additionally, more patients had VTE prophylaxis suspended post-intervention, with the average suspension duration decreasing from 3.2 days in 13 patients, to 5.4 days in 9 patients. Increased monitoring prevented an associated rise in missed doses. No VTE-related harm occurred post- intervention, compared to one case pre-intervention.
Conclusion: The integration of an automated HEPMA report and structured ward handover has reduced missed doses of VTE prophylaxis. The HEPMA reporting system, created in collaboration with HEPMA technicians and enhanced with artificial intelligence, highlights HEPMA’s potential as a sustainable, low-cost tool in quality improvement, enhancing inpatient prescribing safety.
