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The red blood cell utilization review experience
1Pathology and Laboratory Medicine Department, Department of Veterans Affairs Medical Center, West Los Angeles, CA 90073, USA.
Transfusion Science
|February 6, 1998
Summary
Peer review of blood transfusions, established in 1984, often finds over 90% appropriateness. This comprehensive process rarely identifies opportunities for improvement due to a low number of inappropriate transfusions.
Area of Science:
- Healthcare Quality
- Medical Peer Review
- Transfusion Medicine
Background:
- The Joint Commission on Accreditation of Healthcare Organizations introduced a comprehensive peer-review process for blood transfusions in 1984.
- This process involves retrospective, bi-level, chart-based review with initial screening and physician evaluation.
Purpose of the Study:
- To evaluate the efficacy of the established peer-review process for blood transfusions.
- To determine if the current peer-review system effectively identifies areas for improvement in transfusion practices.
Main Methods:
- Systematic review and evaluation of studies assessing the blood transfusion peer-review process.
- Analysis of transfusion appropriateness rates and identification of inappropriate cases across multiple studies.
Main Results:
- In two-thirds of evaluated studies, over 90% of blood transfusions were deemed appropriate.
- Most reporting hospitals documented no instances of inappropriate transfusions.
- The peer-review process frequently yielded too few inappropriate cases to readily identify improvement opportunities.
Conclusions:
- The current comprehensive peer-review system for blood transfusions is often highly effective in ensuring appropriate usage.
- The process's efficacy in identifying improvement opportunities is limited by the low incidence of inappropriate transfusions.
- Further refinement of peer-review methodologies may be needed to better pinpoint areas for enhancing transfusion safety and efficiency.