Venous thromboembolism (VTE) remains a critical concern for healthcare providers, especially within Ambulatory Surgery Centers, Office-Based Surgery facilities, and International Surgical facilities accredited by QUAD A and classified under Anesthesia Classifications B, C-M, and C. The QUAD A Standard 8-B-23 requires that every patient undergo a thorough pre-operative VTE risk assessment as part of their clinical documentation. This protocol is integral, not merely a procedural formality, as it aims to identify individuals at risk for venous thromboembolism, ensuring timely interventions—pharmaceutical, physical, or otherwise. By incorporating a structured VTE risk assessment tool within your facility's manual, you are better equipped to tailor patient care - enhancing outcomes and adhering to national best practices such as the Caprini Risk Assessment Tool.
QUAD A standard 8-B-23 requires the following:
The pre-operative clinical record includes a written screening protocol for venous thromboembolism (VTE) risk. This protocol and assessment tool is to be place in the facility manual for reference.
The VTE risk assessment is a part of the pre-operative documentation required for every patient regardless of the type of procedures being performed at the facility. The main goal of the VTE risk assessment tool is to alert the practitioners that this patient has or is at risk of developing blood clots that may need pharmaceutical or physical intervention prior to, during, or after surgery.
This includes the possibility that this patient may not be appropriate for an ambulatory surgery setting, that the facility may need to provide additional padding during positioning of the patient, or that the patient could benefit from compression devices (TED hose or sequential compression devices) or warming devices during the procedure. Even if the proposed procedure is short and would not necessarily utilize pharmaceutical interventions if the VTE tool indicated the patient was a high risk, there are multiple facets to this issue that still must be considered.
QUAD A does not specify the elements of the VTE risk assessment, but it should be appropriate for your facility’s patient population. Facilities are expected to implement a risk assessment consistent with national standards of practice. One such nationally accepted standard of practice is the Caprini Risk Assessment Tool for VTE, which can be modified for the ambulatory surgery setting. Examples of this tool are available on the internet.
References that you may find helpful include the following:
- Caprini risk assessment model for venous thromboembolism
- AORN guidelines for the prevention of VTE. These guidelines can be found here, and additional information can be found with member access: https://www.aorn.org/article/key-takeaways-6-critical-guideline-updates-to-prevent-vte.
Since 1980, QUAD A (a non-profit, physician-founded and led global accreditation organization) has worked with thousands of healthcare facilities to standardize and improve the quality of healthcare they provide – believing that patient safety should always come first.
