Patient Journey’s in Venous Thromboembolism (VTE): A Comprehensive Model of the Drivers of Self-Reported Patient Risks and Harms as they Transition from Hospital to Home

The overall goals of this project are to: (1) understand patients’ venous thromboembolism (VTE) care experience during transitions of care (TOC) across various settings; (2) build a novel patient-centric statistical model of factors driving success and adversity in VTE care; (3) use this model to identify potential VTE care intervention targets; and (4) validate the model by implementing targeted VTE care interventions in the University of Utah Health Care (UUHC) Thrombosis Services and measuring associated care outcomes. Specific objectives include using themes from qualitative online interviews with VTE patients across the country (n=20) to inform a national survey of VTE sufferers (n=1000). This survey will quantify the TOC ‘flow’ in VTE across and between health care settings, and be used to build a comprehensive and novel statistical model of the drivers of TOC risks and harms and the role of adherence and other patient factors in exacerbating or mitigating risk of subsequent harm (VTE recurrence, bleeding, post-thrombotic syndrome, etc.).  This model will be used to size and operationally prioritize patients most at risk of adverse outcomes during TOC, and provide a computer simulation to illustrate the potential reductions in harms achievable by changing care practices at key TOC points. This model will inform the implementation of empirically defined targeted interventions across inpatient and outpatient settings in UUHC Thrombosis Services, which will be evaluated by contrasting cohorts of patients in the UUHCS system on VTE harms (~n=500), leveraging electronic medical records and patient self-reports.