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A benchmarking program to reduce red blood cell outdating: implementation, evaluation, and a conceptual framework.

Rebecca L Barty¹, Kathleen Gagliardi², Wendy Owens²

¹Department of Medicine, Hamilton, Ontario.

|March 17, 2015

Summary

A quality improvement initiative reduced red blood cell (RBC) outdating in Ontario hospitals. The benchmarking program led to sustained reductions in RBC outdating rates across the province.

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Area of Science:

Healthcare Quality Improvement
Transfusion Medicine
Health Services Research

Background:

Benchmarking is a quality improvement strategy comparing organizational performance to peers.
Previous work established evidence-based benchmarks for red blood cell (RBC) outdating in Ontario.

Purpose of the Study:

To describe the implementation process of a provincewide RBC outdating benchmarking program.
To evaluate the impact of this program on RBC outdating rates in Ontario hospitals.
To develop a conceptual framework for continuous quality improvement in benchmarking.

Main Methods:

Implementation of provincewide benchmarks across 160 hospitals using education, inventory tools, best practice summaries, and recognition.
Utilized RBC hospital disposition data from Canadian Blood Services for benchmarking.
Developed audit tools and a conceptual framework for continuous quality improvement.

Main Results:

Sustained downward trend in RBC outdating rates from April 2006 to February 2012.
Outdating rate decreased from a high of 2.82% annually to a low of 1.02% in 2011.
Key success factors included dynamic targets, comprehensive implementation, information sharing, and robust data systems.

Conclusions:

The Ontario RBC outdating benchmarking program achieved continuous and sustained quality improvement.
An iterative conceptual framework was developed to guide institutions in implementing benchmarking programs.