Quality assessment of transfusion practice in elective surgery

Area of Science:

• Medical Practice
• Quality Improvement
• Transfusion Medicine

Background:

• Blood transfusion practices in elective surgery require optimization.
• Quality assurance (QA) programs can enhance patient blood management.
• Hospitals need systematic approaches to improve transfusion safety and efficacy.

Purpose of the Study:

• To implement and evaluate a quality assurance program for blood transfusion in elective surgery.
• To identify and address common issues in blood transfusion practices.
• To reduce blood misuse and improve transfusion outcomes.

Main Methods:

• Established a multidisciplinary QA group to identify key indicators and set up an organizational structure.
• Collected data over a 1-year implementation period across ten surgical departments.
• Conducted a pilot study in one department, comparing pre- and post-implementation transfusion data.

Main Results:

• Initial data revealed widespread blood misuse, including overrequest, overtransfusion, and excessive reconstitution of whole blood.
• The pilot study demonstrated a significant post-implementation reduction (approximately two-thirds) in overtransfusion.
• Rates of overrequest, whole blood reconstitution, and predeposit use remained largely unchanged in the pilot phase.

Conclusions:

• The quality assurance program shows promise in reducing overtransfusion during elective surgery.
• Further evaluation is needed to assess the program's long-term effectiveness and impact on other transfusion indicators.
• Sustained implementation is recommended to achieve comprehensive improvements in blood transfusion practices.