Improving thromboprophylaxis in the medical inpatients: The role of the resident in an academic hospital

Introduction: Venous thromboembolism (VTE) is one of the main causes of preventable in-hospital death. It is recommended for hospitals to have an appropriate thromboprophylaxis (TP) protocol to avoid VTE complications. Objective: To determine the effect of the resident physician feedback to the staff physician in TP appropriateness after the Caprini RAM score implementation. Methods: Caprini RAM was implemented by the residents in medical patients. Patients were divided in low, moderate, high, and highest-risk groups, with TP recommendation accordingly. In cases with inadequate TP, the resident provided feedback to the staff physician for adjustment. Change to appropriate TP was assessed retrospectively. Results: A total of 265 records were included. Before intervention, 193 (72.8%) patients had appropriate TP and post-intervention, 207 (78.1%) patients received adequate TP (p <.001). Conclusions: Feedback from the internal medicine resident to staff physician improves appropriate TP in medical inpatients as a quality of care strategy.