Does Teaching Improve VTE Risk Assessment? A Quality Improvement Project in Elective Caesarean Section Following the RCOG Green-top Guideline 37a Position Statement

Author : Majd Alkhoury

Abstract : Background: Venous thromboembolism is a leading cause of maternal death in the UK. RCOG Green top Guideline 37a recommends individual VTE risk assessment in pregnancy and the puerperium, including caesarean section, to guide thromboprophylaxis (RCOG, 2015; MBRRACE-UK, 2024). Aim: To assess whether VTE risk scores were correctly calculated for women undergoing elective caesarean section, and whether a departmental teaching session on the updated position statement improved accuracy. Methods: A pre- and post-intervention audit was conducted. Baseline data were collected over two weeks, and each score was checked against RCOG criteria. The intervention was a whole-department teaching session. A two-week re-audit used the same criteria. Results: At baseline, 46/55 (83.6%) of scores were correct, compared with 51/62 (82.3%) at re-audit. Errors persisted, missed or incomplete risk factors, scoring errors or wrong risk category. Conclusion: A single teaching session did not meaningfully improve scoring accuracy, suggesting education alone is insufficient to change practice. Further quality improvement projects and audits will test system-based interventions, such as embedded electronic checklist on the patient electronic system used by the hospital followed by re-audit.

Keywords : Venous thromboembolism, pregnancy, caesarean section, risk assessment, quality improvement, clinical audit.

Conference Name : International Conference on Healthcare Quality and Innovation (ICHQI - 26)

Conference Place : Tokyo, Japan

Conference Date : 26th Oct 2026