A persuasive intervention: improving the compliance of extended venous thromboembolism prophylaxis following cancer resections in a tertiary colorectal and hepatobiliary unit

Extended venous thromboembolism (VTE) prophylaxis has been shown to reduce the incidence of VTE in patients following cancer resections.[1] However, ensuring patients are discharged with the prescription remains a challenge, with junior doctors frequently rotating throughout different specialties. We conducted an audit to assess the compliance rate in the colorectal and hepatobiliary (HPB) unit at the Queen's Medical Centre in Nottingham. Extended VTE prophylaxis was considered compliant to the guideline if it was prescribed on discharge. The baseline measurement demonstrated compliance rates of 79% and 48% in the colorectal and HPB units respectively. Following discussion with the stakeholders, several interventions that include education and visual reminders were implemented to increase awareness of the importance of extended VTE prophylaxis among junior doctors. Results of the re-audit have shown a remarkable improvement; compliance rates were increased to 93% and 72% in the colorectal and HPB units respectively. We conclude that visual reminder is a simple yet effective tool to improve awareness among junior doctors on the importance of extended VTE prophylaxis in cancer patients. Nevertheless, education remains crucial to ensure the sustainability of any intervention.