Melanie's Corner
Dear Friends,
We at the Coalition to Prevent Deep-Vein Thrombosis (DVT) are excited to launch
the Fifth-Annual DVT Awareness Month this March. It's hard to believe that five
years can go by so quickly, and it's equally amazing how far we have reached, how
many lives we've touched, and the differences we have made working together during
that time. Consider some of the benchmarks:
The public is increasingly aware of DVT. According to a study conducted by the Coalition
four years ago, 74 percent of Americans surveyed had never heard of DVT; today 40
percent surveyed have heard or read about it recently.
- When it began in January 2004, the Coalition's membership stood at 27 organizations.
Today that number has nearly doubled to 56 organizations representing medical societies,
patient advocacy groups and a broad span of public health organizations.
- Since the Coalition's formation, more than one billion educational messages have
been delivered through educational, communications and grassroots activities.
- The public is increasingly aware of DVT. According to a study conducted by the Coalition
four years ago, 74 percent of Americans surveyed had never heard of DVT; today 40
percent surveyed have heard or read about it recently.
Our goal this year is to build upon the success of our earlier efforts to achieve
greater levels of awareness and public health impact. Last year's campaign,DVT Awareness
by Design, was so well received on the national and grassroots levels with
more than 2,700 hospitals across the country participating – that's close to half
of all hospitals in the U.S. Due to the great success of the campaign in terms of
awareness-raising and overall impact, we are expanding DVT Awareness by Design
into 2008.
Details for DVT Awareness by Design and DVT Awareness Month were an exciting
portion of the Coalition's annual meeting in late January. Members heard the beat
of runway music while local models, showing DVT-themed socks, carried the new DVT
Awareness by Design kits to attendees via the classic "red carpet." Clearly,
meeting attendees were engaged and energized by the concept and they began the year
ready to carry on our commitment to raise awareness and reduce the risks of DVT.
For more about this year's campaign, see DVT Awareness by Design: Showing & Sharing
Knowledge.
Through my work as the Coalition's National Patient Spokesperson, I have grown to
learn just how powerful knowledge and information can be. The Coalition's commitment
is making a difference for patients and their loved ones. I would like to thank
those of you who attended the January meeting, as well as all those who continue
to support the Coalition's ongoing efforts. I look forward to a busy but productive
DVT Awareness Month and am grateful to all who continue to share their stories,
insight and support.
Coalition's Annual Meeting Sparks
Interactive Exchange of Ideas, Insights
The annual January Coalition meeting, January 31, 2008 in Washington, D.C., provided
an interactive forum for members to exchange ideas and move 2008 programming forward.
Nearly half of the Coalition's growing membership was represented as we hosted 33
attendees from 26 member organizations. This year's meeting brought new inspiration
and excitement as attendees enjoyed a Town Hall format and hands-on kiosks that
mirrored the engaging, interactive full-day session.
Anchored around the three major themes of 2008 -- Quality Care, Patient Education
and DVT Awareness Month – sessions and displays were informative and effective.
Steering committee members staffed the educational kiosks at various times during
the day and leaders also chaired or hosted cross-disciplinary educational sessions
in each topic area. Following these panel presentations, attendees broke into small
groups to share ideas and experiences that further support the Coalition's mission.
Quality Care educational presentations
featured representatives from the Centers for Medicare and Medicaid Services (CMS),
the Joint Commission (JC) and the National Quality Forum (NQF). CMS's Tom Valuck,
M.D., detailed the agency's initiative aimed at reducing the impact of hospital-acquired
conditions. While conditions such as "object left in surgery" and "air embolism"
were selected for CMS implementation by fiscal year 2009, DVT and venous thromboembolism
(VTE) are under consideration as possible provisions going forward. Following Dr.
Valuck, Melinda Murphy, R.N., M.S., C.N.A., from the NQF discussed the national
voluntary consensus standards for prevention and care of VTE. Harriet Gammon, M.S.N,
R.N., C.P.H.Q., from the JC followed with a discussion on the testing of the measures.
In the parallel Providing Quality Care breakout group, participants recommended
the groundbreaking idea – to declare March 19, 2008 as National DVT Screening Day
– as a way to better educate the healthcare community about the need to appropriately
risk-assess patients and ensure their transitions of care.
The Patient Education panel
featured DVT patient spokesperson Bonnie Bernstein, along with insights and ideas
on managing transitions of care. Nancy Skinner, R.N., from the Case Management Society
of America (CMSA) addressed the common ground between hospitals and payor groups
and the intersection of quality and evidence-based care. Steering Committee Member
Ruth Morrison, R.N., B.S.N., C.V.N., discussed the Coalition's plans to launch the
Patient Support Toolkit in 2008 to drive DVT awareness and encourage dialogue between
healthcare professionals and patients.
In the related breakout group ––Informing Patients about DVT Education – participants
provided feedback to make the Patient Support Toolkit easy to use, and they strategized
ways to promote its dissemination. Foremost among those strategies: enlisting the
support and involvement of all Coalition members.
DVT Awareness Month panel presentations
featured Steering Committee Member Dr. Frank Michota, M.D., F.A.C.P. and Coalition
National Patient Spokesperson, Melanie Bloom, who teamed up to unveil the Coalition's
plans for DVT Awareness Month 2008. DVT Awareness by Design took center stage. For
more information on the campaign, see "DVT Awareness by Design: Showing & Sharing
Knowledge" in this issue.
The parallel breakout group fostered ideas to promote grassroots implementation
of the campaign. Tapping the powerful support of Coalition members and harnessing
the power of the Internet with potential new components on www.preventdvt.org were
high atop the list of suggested ideas. All attendees then closed the day with a
plenary session in which they shared and discussed outcomes of each breakout group.
Membership on the Grow
The Coalition continues to grow and has welcomed nine new members this year:
- Blue Cross / Blue Shield of Tennessee
- Genesee Orthopedics
- Medstar Health
- Morristown Memorial Hospital
- Ochsner Medical Center
- Society for Vascular Nursing
- St. Francis Hospital
- University of Iowa Hospitals and Clinics
- University of Texas M.D. Anderson Cancer Center
DVT Awareness by Design: Showing & Sharing Knowledge
Visual, vibrant and a proven way to spread awareness about Deep-Vein Thrombosis
(DVT), DVT Awareness by Design 2008 is the Coalition's educational initiative and
a key component of DVT Awareness Month. The campaign includes a nationwide hospital
and policy-based tour; and with a new focus on fashion, the Coalition's campaign
partners with Parsons The New School for Design, one of the world's leading centers
for design education.
For patients, their families, the general public and healthcare providers, this
exciting program evolved from the fun fashion shows that many of last year's participants
creatively devised and hosted. Now, enhanced design kits and additional campaign
materials are available to guide participants in designing DVT-themed socks and
hosting their own fashion show. Decorating and proudly wearing DVT-themed socks
actively engages patients, employees and the public to be more aware of DVT risks.
In-Practice: Calling all HCP's to Step-Up Screening for DVT
This year the Coalition to Prevent DVT is turning awareness into action as we join
forces to declare National DVT Screening Day, as part of DVT Awareness Month this
March.
The genesis of the National DVT Screening Day was this year's Coalition Meeting
and ideas generated in the Patient Education breakout session hosted by Geno Merli,
M.D., Thomas Jefferson Medical Center, as well as the panel discussion on Establishing
Standards of Care. In particular, trends in the Centers for Medicare & Medicaid
Services' (CMS) pay for performance initiative, presented by Tom Valuck, M.D., CMS,
demonstrate the value of taking a more proactive approach to DVT diagnosis and treatment.
As a result, the Coalition is challenging hospitals across the country to assess
patients' risk for DVT and its primary complication, pulmonary embolism (PE). Effective
treatment options and lifestyle modifications may reduce the risk for both DVT and
PE, so raising awareness of the risks is the first step to improving diagnosis and
reducing the risk of death and disability that DVT and its complications may cause.
To learn more about the CMS expansion of its set of inpatient hospital quality measures
as part of a "continuing commitment to quality improvement in both clinical care
patient safety" visit
http://www.cms.hhs.gov/HospitalQualityInits/35_HospitalPremier.asp
We encourage hospitals and other organizations to support the Coalition's efforts
to further raise awareness of DVT and promote measures that will address and close
the gap between risk assessment and patient understanding.
Coalition Members in Action: Guidelines Grow in Impact, Prevalence
Coalition members are making strides to establish and implement national standards
for clinical action to reduce the risk of DVT and Venous Thromboembolism (VTE).
Such standards can and are becoming part of a measurable difference in hospital
and physician quality programs. The focus on quality helps assure that awareness
and treatment of DVT become, in fact, a standard – not an afterthought
Among the groups leading the charge in evidence-based guidelines are the Case Management
Society of America (CMSA) and the American College of Chest Physicians (ACCP).
CMSA guidelines seek the common ground between hospitals and payor groups, as well
the intersection of quality, evidence-based care, and fiscal responsibility, according
to Nancy Skinner, R.N., CMSA, in a recent presentation to the Coalition. Skinner
is co-author of CMSA's new Deep Vein Thrombosis Addendum to its Case Management
Adherence Guidelines (CMAG.) CMSA introduced the CMAG as a set of guiding principles
and tools it developed to assess, plan, help and advocate for patient adherence.
The DVT Addendum to the basic CMAG program uses the concepts of motivational interviewing,
assessment of health literacy, and implementation of adherence tools, to promote
adherence in patients who are diagnosed with or at risk for developing DVT. The
comprehensive 60-page addendum, available electronically at
http://www.cmsa.org/portals/0/pdf/CMAG_DVT.pdf,
reviews adherence issues including compliance to evidence-based guidelines as well
as patient compliance with prescribed treatment plans. Key quality indicators associated
with the prevention of VTE are also reviewed, as well as motivation and knowledge
tools for patient education.
In a similar focus, Coalition member organization the ACCP, a pioneer in the development
of guidelines for the prophylaxis and treatment of DVT and PE, published its first
such guidelines in the journal Chest in 2004 as part of a larger body of work on
anti-thrombotic therapy, dating back to 1986. A revision of these guidelines is
expected to be published in mid-2008 and they will reflect the latest research on
DVT, stroke prevention, and more. For more information on release of the latest
guidelines, please visit www.chestnet.org.