Using Quality Improvement to Optimize Blood Product Utilization in a Pediatric Cardiac Catheterization Laboratory

Area of Science:

• Pediatric Cardiology
• Health Services Research
• Transfusion Medicine

Background:

• Packed red blood cells (PRBC) are frequently ordered for pediatric cardiac catheterization.
• This practice increases resource utilization and patient charges.
• Optimization of PRBC ordering protocols is needed.

Purpose of the Study:

• To optimize the ordering of PRBC for pediatric cardiac procedures using the Plan-Do-Study-Act (PDSA) principle.
• To increase adherence to PRBC ordering guidelines to over 97%.
• To reduce resource utilization and associated patient charges.

Main Methods:

• Revised existing PRBC ordering guidelines.
• Updated procedure reports to include PRBC administration.
• Monitored pre-procedure PRBC orders, adherence, documentation, transfusion rates, and emergency release blood.

Main Results:

• Adherence to PRBC ordering guidelines increased from 86% to 100% post-implementation.
• Decreased PRBC ordering and hospital charges for low-risk cardiac catheterization procedures.
• No increase in blood transfusions was observed.

Conclusions:

• Implementation of revised PRBC ordering guidelines significantly improved adherence.
• The optimized protocol successfully reduced PRBC utilization and patient charges.
• This approach demonstrates a cost-effective strategy for managing PRBC in pediatric cardiac procedures.