Reducing AB plasma utilisation through the AB plasma appropriateness index.

Area of Science:

• Transfusion Medicine
• Quality Improvement Science
• Clinical Pathology

Background:

• Group AB plasma is a scarce resource with increasing global demand.
• Inappropriate use of group AB plasma in non-group AB patients strains supply.
• The AB plasma appropriateness index (ABAI) was developed to assess and benchmark usage.

Purpose of the Study:

• To identify inappropriate use of group AB plasma.
• To implement a novel key quality indicator (KQI) for monitoring AB plasma usage.
• To modify massive transfusion protocols (MTPs) to reduce inappropriate AB plasma utilization.

Main Methods:

• Retrospective assessment of AB plasma disposition and transfusion indications over 12 months.
• Calculation of the AB plasma appropriateness index (ABAI).
• Implementation of pre-thawed group A plasma for trauma patients starting July 2017.

Main Results:

• Retrospective ABAI indicated significant inappropriate use of AB plasma, primarily to avoid expiry.
• ABAI improved significantly from 0.464 to 0.900 post-implementation (P < 0.0001).
• No significant differences in length of stay or mortality were observed in patients receiving group A plasma.

Conclusions:

• The ABAI serves as a novel KQI to effectively identify and reduce inappropriate AB plasma usage.
• Modification of MTPs to include thawed group A plasma successfully decreased AB plasma waste.
• This quality improvement initiative optimized the use of scarce blood products.