Community hospital participation in a pilot project for venous thromboembolism quality measures: learning, collaboration, and early improvement.

BACKGROUND: Participation in national demonstration projects by hospitals provides opportunities for learning, collaboration, and early improvement. A community teaching hospital, Overlook Hospital, part of the two-hospital Atlantic Health system, participated in a pilot project in the United States with The Joint Commission to develop quality measures for venous thromboembolism (VTE) prevention and management. THE PILOT PROJECT: The VTE project formally began in January 2005, and by January 2007, on the basis of alpha testing to assess face validity and data-collection issues, eight measures were selected for pilot testing. The hospitals tested the quality measures from January through June 2007; data collected included discharges from October 2006 through March 2007. During the pilot, Overlook achieved significant improvements in VTE prevention and management. As a result, in Summer 2007, Atlantic Health developed an organizationwide initiative to improve VTE prevention and treatment.

DISCUSSION: In 2008, the Joint Commission recommended that the VTE measures become a core measure set and be aligned with the Centers for Medicare & Medicaid Services quality measures. Following successful implementation of multiple quality improvement innovations that arose from the pilot project participation, Atlantic Health sustained and expanded its efforts in 2009 to improve'performance on eight VTE quality measures.

CONCLUSIONS: Participation of a broad range of hospitals, including academic medical centers and community hospitals, in a national pilot project to develop quality measures is critical to ensure that differences in environment, resources, staffing, and patient acuity are accounted for, particularly when the measures are used for public reporting.