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The setting up and implementation of a venous thromboembolism prophylaxis policy in clinical hospital practice.

Clinical management policies are meant to lead to the delivery of better health care. However, as we demonstrate in this review, having an oral or written venous thromboembolism prophylaxis policy does not necessarily lead to the majority of general surgical inpatients receiving the appropriate prophylaxis. We discovered, through prospective clinical audit, that for a clinical policy to be effective in delivering the appropriate health care, it must be repeatedly scrutinized and implemented in the correct manner. Only after several rounds of the audit cycle were we able to achieve the deliverance of venous thromboembolism prophylaxis to the majority of general surgical patients on our unit. This has wider implications, not just for the implementation of a venous thromboembolism prophylaxis policy, but also for all clinical management policies, and illustrates the importance of clinical audit in clinical practice.