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A comprehensive approach to continuous quality improvement of massive transfusion by developing key performance
Ancy Ninan1, Vimal Krishnan2, Shamee Shastry1
1Department of Immunohaematology and Blood Transfusion, Kasturba Medical College Manipal, Manipal Academy of Higher Education, Manipal, Udupi, Karnataka, India.
Vox Sanguinis
|September 9, 2024
Summary
This study developed key performance indicators (KPI) to assess goal-directed massive transfusion (GDMT) protocols, revealing areas for quality improvement in transfusion medicine and patient outcomes.
Area of Science:
- Transfusion Medicine
- Emergency Medicine
- Quality Improvement Science
Background:
- Massive transfusion protocols are critical in managing severe hemorrhage.
- Assessing the quality of goal-directed massive transfusion (GDMT) requires robust performance indicators.
- Existing quality assessment methods for GDMT may lack comprehensive key performance indicators (KPIs).
Purpose of the Study:
- To develop and validate key performance indicators (KPIs) for evaluating institutional goal-directed massive transfusion (GDMT) protocols.
- To establish a framework for quality assessment and improvement of GDMT.
- To identify specific metrics for monitoring GDMT effectiveness and efficiency.
Main Methods:
- A cross-sectional data analysis of GDMT in adult patients from January 2021 to December 2022.
- Utilized the Define, Measure, Analyse, Improve, Control (DMAIC) methodology for KPI development.
- Evaluated KPIs based on importance, scientific soundness, and feasibility, using measures of central tendencies and benchmark comparisons.
Main Results:
- Analyzed 92 massive transfusion events involving 1405 blood components, with trauma as the leading indication.
- Appropriate GDMT activation occurred in only 43.47% of events; turnaround time was within benchmark in 85.8%.
- Identified significant variations in blood component utilization and a 3.5% wastage rate, with overall mortality at 45.65%.
Conclusions:
- The developed KPIs are easily capturable and facilitate comprehensive quality assessment of GDMT.
- The study provides a data-driven approach to enhance the effectiveness and efficiency of massive transfusion protocols.
- Implementation of these KPIs can guide targeted improvements in GDMT, potentially impacting patient outcomes.
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