Observations from a national multiple institution autotransfusion (ATS) quality indicator program

A process to collect universal, mandatory autotransfusion (ATS) procedure quality indicators to measure and monitor ATS quality improvement was designed and implemented by Fresenius Medical Care Extracorporeal Alliance (FMCEA) an outsource provider of extracorporeal services. The indicator program collected and evaluated data that reflect real-world extracorporeal clinical practices and outcomes. The indicator reports provide our clinicians, client physicians, and partner institutions with confidential reports that allow comparison of their practice to evidenced-based performance standards. All ATS procedures reviewed were performed on non-open-heart surgery procedures (on pump or off pump), including vascular, thoracic, orthopedic, and general surgery. After continuous collection and analysis of the indicator data, a hospital is given a report with three components: 1) data analysis that reports summary results and benchmarks the hospital against the other reporting hospitals, 2) corrective action plan that allows the clinical manager to document their investigations and outline plans for continuous quality improvement; and 3) raw data tabulation that allows the clinical manager to identify individual cases that are outliers from the target goal to facilitate local chart reviews. This communication describes FMCEA's ATS Quality Indicator Program and presents the collective results for the first 13 months (January 2002--January 2003) of data collection. Physicians and ATS service client hospitals value the Quality Indicator Process Reports. ATS service managers use the reports and the subsequent process improvement to meet AaBB (American Association of Blood Banks) and JCAHO (Joint Commission on Accreditation of Healthcare Organizations) standards and guidelines for providing safe patient-care services.