# Directed evaluation of provider learning modules to prevent venous thromboembolism after major cancer surgery

> **NIH VA I01** · JESSE BROWN VA MEDICAL CENTER · 2020 · —

## Abstract

Venous thromboembolism (VTE), which comprises both deep venous thrombosis (DVT) and pulmonary
embolism (PE), is the most common preventable cause of hospital death. Veterans with cancer, and
particularly those who undergo surgery are at particularly high risk with up to one-third of untreated patients (no
prophylaxis) developing deep venous thrombosis. Guidelines from the American College of Chest Physicians
recommend prophylaxis throughout the hospital course and continuing post discharge for 4 weeks after
surgery. Current hospital process measures (VA Surgical Quality Improvement Program-VASQIP VTE
measure, Joint Commission's Surgical Care Improvement Project SCIP-VTE-2) only examine prophylaxis
during the procedure or in the 24 hours around the time of surgery rendering them inadequate in evaluating
and promoting performance. Collaborative training modules from the Illinois Surgical Quality Improvement
Collaborative (ISQIC) are available to raise awareness of VTE risk and prevention strategies among surgeons,
surgical care teams, nurses and patients. We propose a VISN 12 directed evaluation to determine the effect of
VTE risk education modules on both inpatient and outpatient VTE prophylaxis. We propose the following
Specific Aims:
Aim1: To determine whether multi-modal, provider-focused educational interventions can improve receipt of
VTE inpatient chemoprophylaxis and ordering of post-discharge chemoprophylaxis after major cancer surgery
in four VISN 12 hospitals.
H1: Scalable interventions for postoperative VTE prophylaxis can be effective in addressing local care barriers
to receipt of inpatient chemoprophylaxis and ordering of post-discharge chemoprophylaxis. The interventions
will include the ISQIC VTE Bundle elements: Caprini risk assessment tools, audit/feedback of provider
prescribing habits, risk awareness education for nurses and patients.
Aim 2: To identify patient and nursing provider perceptions of barriers to guideline-concordant care during the
transition from inpatient to outpatient postsurgical VTE prophylaxis.
H1: Inpatient and post-discharge prophylaxis adherence is variable for Veterans after major cancer surgery
due to lack of VTE risk awareness.
Aim 3: To perform a cost identification and budget impact analysis of increasing adherence to VTE prophylaxis
guidelines.
H1: The cost of increased delivery of VTE chemoprophylaxis will be offset by decreased cost of VTE treatment.
These aims will evaluate the implementation of ISQIC training bundles, leveraging the integrated VHA
healthcare delivery system and existing databases to improve surgical outcomes. These interventions build on
prior work identifying gaps in guideline-concordant, post-surgical care and on preliminary testing outside the
VA in the Illinois Surgical Collaborative. This study is innovative in that both quantitative and qualitative
methods will evaluate how providers adopt post-surgical risk education. This study will also provide new
knowledge on the value...

## Key facts

- **NIH application ID:** 9761840
- **Project number:** 5I01HX002290-02
- **Recipient organization:** JESSE BROWN VA MEDICAL CENTER
- **Principal Investigator:** David J Bentrem
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2020
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2018-08-01 → 2022-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9761840

## Citation

> US National Institutes of Health, RePORTER application 9761840, Directed evaluation of provider learning modules to prevent venous thromboembolism after major cancer surgery (5I01HX002290-02). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9761840. Licensed CC0.

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