Blood ordering from the operating room: turnaround time as a quality indicator

Area of Science:

• Transfusion Medicine
• Healthcare Quality Improvement
• Blood Banking Operations

Background:

• Quality indicators are vital for patient safety and satisfaction in transfusion medicine.
• Turnaround time (TAT) for issuing red blood cells (RBCs) is a key quality indicator but lacks established benchmarks.
• This study investigates RBC TAT from blood bank to operating rooms (ORs) at two major academic medical centers.

Purpose of the Study:

• To examine and compare the TAT for issuing RBCs between the blood bank and ORs at Vanderbilt University Medical Center (VUMC) and Stanford University Medical Center (SUMC).
• To assess the current practices of TAT monitoring in transfusion medicine across academic institutions.
• To understand anesthesiologists' expectations regarding RBC TAT in urgent surgical settings.

Main Methods:

• TAT was measured from the time of RBC request to issuance from the blood bank.
• Analysis included cases with completed type-and-screen results and requests for up to four RBC units.
• Surveys were distributed to academic institutions and anesthesiologists to gather data on TAT monitoring and expectations.

Main Results:

• Mean TATs were comparable: VUMC (10 ± 3.8 min) and SUMC (14 ± 7.2 min).
• Common delays included overlapping orders, staff availability, and pneumatic tube system saturation.
• Only 3 of 24 surveyed institutions monitored RBC TAT, while anesthesiologists expected TATs of 5–15 minutes for urgent cases.

Conclusions:

• Many institutions do not monitor stat RBC issue TAT as a quality indicator.
• This study provides a foundation for establishing a benchmark for RBC TAT in transfusion services.
• Standardizing TAT monitoring is essential for improving transfusion medicine efficiency and patient care.