Wednesday, December 02, 2009

Hospital acquired DVT and PE: never say never!

That seems to be the opinion of the authors of this recent Green Journal paper on Medicare's never events policy as it pertains to VTE:

Although prophylaxis is cost effective, the net effect of the “never event” designation to patient care remains unclear because: the new regulation may discourage aggressive diagnosis of venous thromboembolism once the patient is admitted,14 and prophylaxis does not eliminate the risk completely.

No form of DVT prophylaxis known to medicine, no matter how widely applied, can prevent all DVTs.

The article goes on:

Any system that incorporates a punitive component risks limiting full disclosure and encouraging the release of incomplete data about patient safety.14 Clinicians and institutions might curtail diagnostic procedures that are associated with these disincentives.15

That's an example of what I meant when I said the new culture of blame undermines transparency.

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