Research indicates improvements in incidents of Hospital Acquired Thrombosis (HATs) across Welsh health boards

Around 1,250 people in Wales each year are at risk of dying from Hospital Acquired Thrombosis (HAT), following admission to hospital for surgery or an acute medical illness.

This is when a blood clot forms in the deep veins of the legs (deep vein thrombosis) and subsequently breaks off and lodges in the lungs (pulmonary embolus).

This is more than the number of patients dying from breast cancer, road traffic accidents and AIDS combined.

Not all these deaths are avoidable but many are with simple preventative treatment called thromboprophylaxis.

Thrombosis can also have long-term physical and psychological effect on survivors; up to 40% of patients develop post thrombotic syndrome comprising of chronic pain, swelling and ulceration of the legs. Some research has identified long term psychological symptoms resembling Post Traumatic Stress Disorder.

Since 2012, reducing avoidable harm and mortality from HATs has been a top priority for Welsh health boards, who’ve been taking a standardised approach to risk assessing patients for a HAT using thromboprophylaxis, followed by a form of Root Cause Analysis where risk is identified.

We have seen huge improvements across the Principality in the prevention of hospital-acquired thrombosis

Clinicians in Wales, working in collaboration Welsh Government, agreed a measurement and reporting strategy, which encourages organisations not only to identify but to study the causes of any potentially avoidable HAT.

Every health board with a district general hospital is now using the same method for assessing patients and collecting data on potential HAT incidents – using a definition agreed by the all-Wales HAT Steering Group.

Professor Simon Noble, Chair of the All Wales HAT steering group said: "We have seen huge improvements across the Principality in the prevention of hospital-acquired thrombosis. This is a direct result of the Welsh Government listening to healthcare professionals and working with them to agree a standardised and workable approach to HAT prevention."

There is more focus on thromboprophylaxis than ever before

Andrea Croft, of Abertawe Bro Morgannwg University Health Board and Nurse Director of Thrombosis UK added: "There is more focus on thromboprophylaxis than ever before, which has made a huge difference to assuring the uptake of risk VTE risk assessment in Welsh hospitals is achieved; resulting in early signs of a reduction in Hospital Acquired Thrombosis."

In 2014, a national public facing ‘Ask About Clots’ campaign was developed (supported by 1000 Lives Improvement) to encourage patients to ask healthcare professionals about their risk of developing a blood clot -

Despite its success in awareness raising of the risks of clots, it is in the implementation of standardised practice across Wales (using agreed mechanisms for collecting, reporting and reviewing data) where the greatest improvements have been made. Recent analysis has shown an increase in the number of HAT assessments being performed which should result in the number of HAT incidents decreasing.

The work of the all-Wales HAT group has been recognised as good practice by other parts of the UK and Europe.

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