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Audit-based corrective and preventive actions to reduce wastage of blood components at a single blood center: A
John Gnanaraj1, Rajendra Kulkarni1, Dibyajyoti Sahoo1
1Department of Transfusion Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
Insights
Implementing corrective actions significantly reduced blood component discard rates from 5% to 3% over four cycles. Continuous quality improvement is crucial for blood centers.
Area of Science:
- Transfusion Medicine
- Healthcare Quality Improvement
- Clinical Pathology
Background:
- Blood component wastage rate impacts overall blood product quality and efficiency.
- Key performance indicators (KPIs) like QC failure, transfusion-transmitted infection (TTI) positivity, and component discards are vital for identifying improvement areas.
- Monitoring these indicators over time can reveal trends and the effectiveness of interventions.
Purpose of the Study:
- To assess the impact of a quality improvement program on reducing blood component discard rates.
- To identify and address factors contributing to blood product unusability.
- To evaluate the effectiveness of corrective and preventive actions in improving blood center KPIs.
Main Methods:
- A clinical audit and quality improvement study was conducted over four cycles (16 months).
- Each cycle involved data analysis for KPIs, identification of causes for poor performance, implementation of corrective plans, and subsequent data collection.
- Data were managed using Microsoft Excel and analyzed with SPSS version 19.
Main Results:
- The overall blood component discard rate decreased from approximately 5% at the start to 3% by the end of the four cycles.
- Statistical analysis showed a significant reduction in discard rates (P < 0.05).
- Interventions targeted preparatory processes, preparation methods, and inventory management.
Conclusions:
- Corrective and preventive actions are effective in rectifying deviations in blood center KPIs.
- Continuous monitoring and improvement of quality indicators are essential responsibilities for blood center directors, staff, and clinicians.
- The study demonstrates the feasibility of improving blood product quality and reducing waste through systematic interventions.
Introduction:
The rate of discarded blood components or "wastage rate" reflects on the whole process, preparation, and production of blood and its quality control. It is the ratio of blood and blood components discarded to the total number of collections. The discard or unusability of blood products are many, and the ones that can be monitored and regarded as indicators to be improvised on are QC failure rate, transfusion-transmitted infection (TTI) positivity, and component discards (other than TTI), including those that caused transfusion reactions. These were studied over four intervention cycles to see if they could be improved.
Materials And Methods:
This was a clinical audit and quality improvement study. The clinical audit was conducted over four cycles over 16 months. Each cycle included three stages wherein the data required for calculating those key performance indicators (KPIs) of the blood center were studied and analyzed, and causes for the poorly performing ones were identified; a corrective plan was drawn and implemented, followed by data collection and interpretation of the same in the next cycle for improvement. The data were compiled using a Microsoft Excel spreadsheet and analyzed using SPSS version 19 (IBM Corporation, New York, USA).
Results:
The overall discard rates due to all cumulative causes mentioned were at about 5% at the start of the first cycle. The various factors comprising preparatory, preparation, and the management of inventory and issue were analyzed, and corrective interventions were performed in every cycle. The discard rates were reduced to about 3% by the end of the four cycles. The difference was statistically significant, with a P < 0.05.
Conclusion:
The implementation of Corrective and preventive action measures can rectify the deviations in KPIs. The blood center director, staff, and doctors should be responsible for maintaining and continuously improving the quality indicators.
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