How did we reform our out of control massive transfusion protocol program?

Area of Science:

• Transfusion Medicine
• Healthcare Management

Background:

• Massive transfusion protocol (MTP) activation increased over tenfold between 2008 and 2015 at an academic medical center.
• This rise placed significant stress on the transfusion service.

Purpose of the Study:

• To reform the existing massive transfusion protocol (MTP) in response to increased activation frequency.
• To identify key areas for improvement within the MTP.

Main Methods:

• A multidisciplinary root cause analysis (RCA) was conducted with numerous stakeholders.
• Four principal opportunities for improvement (OFI) were identified: education, stewardship, process improvement, and communication.

Main Results:

• Implementation of new approaches targeting the identified OFIs led to reduced MTP activations.
• Blood product waste and stress on transfusion service technologists were significantly decreased.
• The MTP became better aligned with its intended purpose of rapidly supporting exsanguinating patients.

Conclusions:

• The massive transfusion protocol (MTP) is improvable through systematic analysis.
• Root cause analysis (RCA), while time-intensive, yields substantial benefits including improved communication, reduced stress, and optimized resource utilization.
• Reformed MTP enhances efficiency and patient care alignment.