{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T19:03:22Z","timestamp":1785438202015,"version":"3.56.0"},"reference-count":42,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T00:00:00Z","timestamp":1773792000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Venous thromboembolism (VTE) prevention and management has been identified as a key priority area for healthcare quality and safety in Chinese hospitals. The National Health Commission has incorporated \u201cimproving the standardized prophylaxis rate for venous thromboembolism\u201d as one of the national medical quality and safety improvement goals for China from 2021 to 2025. While large tertiary hospitals in China have actively implemented VTE prevention and management systems with notable success, significant challenges persist at the grassroots level, including insufficient VTE prevention capabilities and low awareness in county-level and township hospitals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Inpatients from the consortium (comprising 1 county-level hospital and 6 township hospitals) between July 2023 and June 2025 were selected as the study population. July 2024 was designated as the project initiation timepoint. The period from July 2023 to June 2024 was defined as the pre-intervention phase serving as the control group (CG), while the period from July 2024 to June 2025 was defined as the post-intervention phase serving as the observation group (OG). The analysis focused on trends in changes of indicators such as in-hospital VTE detection\/diagnosis rate, risk assessment rate, bleeding risk assessment rate, mechanical prophylaxis implementation rate, and pharmacological prophylaxis implementation rate before and after the initiation of the VTE prevention and management project.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In the county-level hospital, the observation group comprised 30,863 cases and the control group 31,382 cases. Across the six township hospitals, the observation group included 35,204 cases and the control group 34,751 cases. There were no statistically significant differences in gender, age, or body mass index between the two groups in either the county-level or township hospitals (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;gt;\u202f0.05). In the county-level hospital, the observation group showed significantly higher rates than the control group in VTE risk assessment (99.47% vs. 67.42%), in-hospital VTE detection\/diagnosis (1.42% vs. 0.64%), bleeding risk assessment (79.76% vs. 46.76%), mechanical prophylaxis implementation (46.15% vs. 20.96%), and pharmacological prophylaxis implementation (48.10% vs. 21.71%), with all differences being statistically significant (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.05). Similarly, in the township hospitals, the observation group demonstrated significantly higher rates than the control group in VTE risk assessment (98.43% vs. 23.15%), in-hospital VTE detection\/diagnosis (0.55% vs. 0.26%), bleeding risk assessment (81.25% vs. 41.15%), mechanical prophylaxis implementation (29.28% vs. 14.37%), and pharmacological prophylaxis implementation (8.49% vs. 2.54%), with all differences being statistically significant (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Under the close-knit county medical alliance model and with the application of computer-supported technology, improvements were observed in VTE risk assessment rates, in-hospital VTE detection\/diagnosis rate, bleeding risk assessment rates, mechanical prophylaxis implementation rates, and pharmacological prophylaxis implementation rates in both county-level and township hospitals.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1802075","type":"journal-article","created":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T07:00:48Z","timestamp":1773817248000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Implementation outcomes of a VTE prevention and management system within the close-knit county medical alliance model"],"prefix":"10.3389","volume":"14","author":[{"given":"Xiuli","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Medical, Chengdu Qingbaijiang District People's Hospital","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinwang","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, The First Affiliated Hospital of Chengdu Medical College","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian","family":"Wei","sequence":"additional","affiliation":[{"name":"Department of Healthcare, General Hospital of Western Theater Command of the People's Liberation Army of China","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunxian","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Medical, Chengdu Qingbaijiang District People's Hospital","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Medical, Chengdu Qingbaijiang District People's Hospital","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mali","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Medical, Chengdu Qingbaijiang District People's Hospital","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lingli","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Medical, Chengdu Qingbaijiang District People's Hospital","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Medical, Chengdu Qingbaijiang District People's Hospital","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,18]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"248","DOI":"10.1038\/s41569-022-00787-6","article-title":"Epidemiology and prevention of venous thromboembolism","volume":"20","author":"Lutsey","year":"2023","journal-title":"Nat Rev Cardiol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"666","DOI":"10.1080\/07853890.2018.1538564","article-title":"Update on extended treatment for venous thromboembolism","volume":"50","author":"Pe\u00f1aloza-Mart\u00ednez","year":"2018","journal-title":"Ann Med"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1016\/j.advms.2022.10.002","article-title":"Venous thromboembolism: why is it still a significant health problem?","volume":"68","author":"Oleksiuk-B\u00f3jko","year":"2023","journal-title":"Adv Med Sci"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"277","DOI":"10.1016\/S2213-2600(19)30354-6","article-title":"Trends in mortality related to pulmonary embolism in the European region, 2000-15: analysis of vital registration data from the WHO mortality database","volume":"8","author":"Barco","year":"2020","journal-title":"Lancet Respir Med"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"44","DOI":"10.36401\/JQSH-20-27","article-title":"Reducing the length of stay by enhancing the patient discharge process: using quality improvement tools to optimize hospital efficiency","volume":"4","author":"Abuzied","year":"2021","journal-title":"Glob J Qual Saf Healthc"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"1340","DOI":"10.1161\/CIRCRESAHA.115.306841","article-title":"Global burden of thrombosis: epidemiologic aspects","volume":"118","author":"Wendelboe","year":"2016","journal-title":"Circ Res"},{"key":"ref7","first-page":"S391","article-title":"Venous thromboembolism: role of pharmacists and managed care considerations","volume":"23","author":"Horner","year":"2017","journal-title":"Am J Manag Care"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"342","DOI":"10.1016\/j.chest.2018.10.040","article-title":"Trends in hospitalization and in-hospital mortality from VTE, 2007 to 2016, in 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informatics","volume":"7","author":"Abuzied","year":"2024","journal-title":"Glob J Qual Saf Healthc"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"e254","DOI":"10.1161\/CIR.0000000000000950","article-title":"Heart disease and stroke statistics-2021 update: a report from the American Heart Association","volume":"143","author":"Virani","year":"2021","journal-title":"Circulation"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"339.e19","DOI":"10.1016\/j.amjmed.2015.10.014","article-title":"Lifetime risk of venous thromboembolism in two cohort studies","volume":"129","author":"Bell","year":"2016","journal-title":"Am J Med"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"829","DOI":"10.1161\/CIRCULATIONAHA.114.009107","article-title":"30-year mortality after venous thromboembolism: a population-based cohort 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care: a cluster-randomized trial","volume":"18","author":"Rothberg","year":"2025","journal-title":"Circ Cardiovasc Qual Outcomes"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"105280","DOI":"10.1016\/j.ijnurstu.2025.105280","article-title":"Refining the program theory of the nurse-led rapid response team in acute care hospitals: a realist evaluation","volume":"174","author":"Bunkenborg","year":"2026","journal-title":"Int J Nurs Stud"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"100866","DOI":"10.1016\/j.lana.2024.100866","article-title":"Venous thromboembolism prevention program implementation in a community oncology practice: a cohort study","volume":"38","author":"Ades","year":"2024","journal-title":"Lancet Reg Health Am"},{"key":"ref39","first-page":"S65","article-title":"Venous thromboembolism","volume":"68","author":"Rosenow","year":"1992","journal-title":"Postgrad Med 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