Background: Elastic compression stocking (ECS) therapy is an important treatment for patients with deep venous thrombosis (DVT) and chronic venous insufficiency (CVI). Practically, the impression exists that there is a substantial variation in how ECS therapy is implemented.
Aims: This study aimed to provide insight into the structure and variability of the elastic compression stocking therapy process, its effects on outcomes, and to elicit improvement themes from a multiple stakeholder perspective.
Methods: This study was conducted in two regions in The Netherlands. Thirty semi-structured interviews with professionals and patients were performed. The study was approved by the medical ethical committee of MUMC+ and all participants gave verbal informed consent. The essential functions for the process of elastic compression stocking therapy were extracted to create two work-as-done models using the Functional Resonance Analysis Method (FRAM). These findings were used to guide discussion between stakeholders to identify improvement themes. The study was funded by a grant from ZonMw, the Netherlands Organisation for Health Research and Development.
Results: Two FRAM models were created (one for each region). The variability of the functions and their effect on outcomes, as well as interdependencies between functions were identified. These were presented in stakeholder meetings to identify the structure of the process and designated variable and uniform parts of the process and its outcomes. Ultimately six improvement themes were identified: dissemination of knowledge of the entire process; optimizing and standardizing initial compression therapy; optimizing timing to contact the medical stocking supplier (when edema has disappeared); improving the implementation of assistive devices; harmonizing follow-up duration for CVI-patients; and personalizing follow-up and treatment duration in DVT-patients.
Conclusions: This study provides a detailed understanding of how elastic compression stocking therapy is delivered in daily practice by describing major functions and variability in performances and elicited six improvement themes from a multi-stakeholder perspective.
To cite this abstract in AMA style:Schreurs RH, Joore MA, Ten Cate H, Ten Cate-Hoek AJ. Using the Functional Resonance Analysis Method to Explore how Elastic Compression Therapy Is Organized and Could Be Improved [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/using-the-functional-resonance-analysis-method-to-explore-how-elastic-compression-therapy-is-organized-and-could-be-improved/. Accessed December 3, 2021.
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