Strategies for the review of transfusion practices

The intent of this report is to familiarize health care professionals with the concept of effective quality assurance in regard to blood use. Although evaluation of the appropriateness of transfusion therapy is now required by the Joint Commission on Accreditation of Health Organizations, health care facilities have little experience with this aspect of professional quality assurance. To this end, the Committee on Transfusion Practices of the American Association of Blood Banks, in Arlington, Va, in this report has provided examples of indications and audit criteria for individual blood components and products and commented on areas of controversy surrounding their use. Audit criteria from different institutions may vary because of differences in local interpretation of the indication, different patient populations, and, in some instances, the availability of blood and laboratory services. Several approaches to the review of transfusion practices are discussed in relation to clinical settings and pertaining to particular blood components. It is evident from these examples that there will be an increased need for trained personnel to perform the initial review process as well as for physicians trained in transfusion medicine to oversee the transfusions and provide the necessary consultation.