Using Blood Wisely: lessons learnt in establishing a national implementation programme to reduce inappropriate red...

Area of Science:

• Healthcare Quality Improvement
• Transfusion Medicine
• Patient Safety

Background:

• Up to 50% of blood transfusions are inappropriate, despite evidence-based guidelines.
• Choosing Wisely Canada initiated the 'Using Blood Wisely' program in 2020 to address inappropriate red blood cell transfusion use.
• The program aimed to engage hospitals in auditing transfusion practices against national benchmarks.

Purpose of the Study:

• To assess the engagement and initial outcomes of the 'Using Blood Wisely' quality improvement program.
• To evaluate hospital participation in auditing and improving red blood cell transfusion practices.
• To identify barriers encountered during the implementation of the program.

Main Methods:

• The 'Using Blood Wisely' program utilized national benchmarks, an audit tool, and evidence-based interventions.
• Hospital engagement was measured by sign-ups, audit completion, survey submission, and designation achievement.
• Barriers to implementation were systematically collected from participating hospitals.

Main Results:

• 229 hospitals (159 groups) representing 72% of Canadian blood use participated.
• 92% completed a baseline audit, and 82% entered multiple audits.
• 51% met benchmarks at baseline, and 39% achieved designation for sustained success.

Conclusions:

• The 'Using Blood Wisely' program achieved substantial and sustained hospital engagement in transfusion quality improvement.
• The large-scale national initiative exceeded expectations in its initial phase.
• Further rigorous evaluation is required to determine the program's impact on transfusion utilization.