Thrombosis is the formation of a blood clot in a blood vessel. Blot clots can be found anywhere in the body, and can cause serious complications if they move to a crucial part of the circulatory system. It is estimated that one in four Canadians die from causes related to blood clots – including heart attack, stroke and venous thromboembolism – the top cardiovascular killers in Canada.
Thrombosis Canada, formerly known as the Thrombosis Interest Group of Canada, has been the voice of vascular medicine in Canada since 1991. Think Research sat down with David Airdrie, Executive Director of Thrombosis Canada, to discuss some of the challenges in this critical field, and how Thrombosis Canada is addressing them.
What is Thrombosis Canada’s mission?
Thrombosis Canada is focused on education and research in the prevention and treatment of thrombotic vascular disease. We know that providing point-of-care clinical guidance and tools, founded on national and international guidelines, is the most effective and cost-efficient way to improve patient safety and outcomes.
What is something people aren’t aware of when it comes to thrombotic vascular disease?
Our research shows that the majority of the Canadian population isn’t aware that thrombotic vascular disease includes heart attack, stroke, peripheral arterial disease (PAD), and venous thromboembolism (VTE). The majority of Canadians with thrombosis suffer from VTE which includes deep vein thrombosis (DVT) and pulmonary embolism (PE). Also, treatment for thrombosis varies. It usually comes in the form of pills but often starts with injections. Doctors use these anticoagulants, commonly called blood thinners, to prevent clots from getting bigger and reduce the likelihood of further clot development.
What is the healthcare issue or problem that you’re trying to address?
First, there is a need to extend thrombosis prevention beyond the hospital walls.
This is important because patients are going home sooner after surgery than ever before, but their risk of developing blood clots remains high whether they remain in hospital or return home). Ensuring proper anticoagulant maintenance is essential to reducing readmission and death. This is especially true for cancer patients who have had surgery, as they’re among the patients at highest risk for developing blood clots after surgery.
Surgical teams can be enabled to implement evidence-based best practices, including the increased use of extended thromboprophylaxis after cancer surgery.
Secondly, there is a need to rapidly identify blood clots when they occur and to promptly initiate potentially life-saving treatment. Front line, primary care physicians are in the best position to do this.
In the emergency department, physicians can be supported in the initiation of appropriate anticoagulation for patients presenting with VTE. There’s an ongoing effort to educate healthcare providers on the right steps at the point of care.
What solutions are in place to help overcome these challenges?
To overcome these challenges, Thrombosis Canada partnered with Think Research to develop customizable Order Sets based on identified clinical needs. See Bleed Management, Extended Thromboprophylaxis, and VTE in the ED Patient Order Sets.
Patient Order Sets are sophisticated medical checklists that offer evidence-based treatment options in a single, user-friendly interface. These Order Sets align with our mission to educate clinicians, as they include the latest medical research, best-practices and guidelines. They are designed to fit seamlessly into any healthcare organization’s unique workflow.
They can result in significant improvement in outcomes. For instance, research by the Canadian Patient Safety Institute has shown that when Order Sets are used, appropriate thromboprophylaxis was administered in 94% of patients, compared to 78% when order sets were not used.
By utilizing Patient Order Sets we’re able to:
- Empower healthcare providers to effectively manage thrombotic vascular disease
- Ensure timely initiation of vascular risk reduction strategies for both primary and secondary prevention
- Have fewer acute vascular events and improve vascular outcomes
- Improve patient safety
- Reduce emergency room utilization
- Provide early, appropriate hospital discharge and seamless transition to the primary care setting
- Improve early post-discharge management to reduce ER visits and hospital readmissions
- Optimize resource utilization by promoting appropriate use of laboratory testing and imaging
What exact conditions are you trying to address through this effort?
- Extended thromboprophylaxis for patients after abdominopelvic cancer or other high-risk surgery
- VTE presenting in the emergency department
- Anticoagulant-related bleeding management
Who are these Order Sets used by?
These Order Sets are largely used by hospital-based provider teams and thrombosis experts, particularly surgeons and emergency physicians. The Extended Thrombosis Prophylaxis Order Set targets surgeons and surgical staff as it focuses on current in-hospital patients. The most recent Order Set, which specializes on VTEs, is most supportive to emergency doctors.
What prompted you to work with Think Research?
Think Research specializes in organizing the world’s health knowledge so everyone gets the best care. Thrombosis Canada wanted to partner with Think Research because clinical guides are at the core of what they do. With over 30 in-house and 100 consulting clinicians involved in knowledge translation, Think Research’s Patient Order Sets enable clinicians, surgeons, and other healthcare providers to deliver effective treatment options for better patient outcomes. The goal of using Think Research’s Order Sets is to encourage providers to prevent clots overall and increase adherence to guidelines (whereas other tools help more with maintenance).
What are the primary challenges your organization faces?
Our biggest challenge is in building awareness of the organization and delivering on our mission to further education and research in thrombotic vascular disease. In an environment of 24/7 news and information flow, we’re constantly looking for ways to stand out and reach healthcare providers and the public. For more information about what we do, and our resources and tools (including information about the Order Sets), please visit our website at www.thrombosiscanada.ca.
Working with Think Research has allowed us to reach healthcare providers through evidence-based tools such as Patient Order Sets. Physicians can see the tool in action and request a demo here. To find out more about Patient Order Sets contact firstname.lastname@example.org.