Evaluating the effects of a hospital utilisation improvement program on platelet transfusions: A pre-post study

Area of Science:

• Hematology
• Transfusion Medicine
• Healthcare Management

Background:

• Millions of platelet concentrate (PC) transfusions occur globally each year.
• Complex decisions surrounding PC transfusions necessitate standardized hospital programs.
• Such programs aim to optimize patient outcomes by ensuring appropriate PC utilization.

Purpose of the Study:

• To evaluate the impact of a new hospital utilization improvement program on platelet concentrate transfusions.
• To analyze changes in transfusion appropriateness and patterns following program implementation.

Main Methods:

• Retrospective analysis of PC transfusions in adult patients at a large academic medical center.
• Comparison of 12-month periods before and after program introduction, based on clinical practice guidelines.
• Program components included intranet resources, mandatory e-learning, and modified computerized physician order entry.

Main Results:

• The overall transfusion rate was 0.17%.
• Median pre-transfusion platelet counts decreased post-program (28 to 24 × 10^9/L).
• Appropriateness of PC transfusions increased significantly (48.4% to 59.9%), with higher appropriateness for therapeutic transfusions.

Conclusions:

• A straightforward hospital utilization improvement program can effectively enhance the appropriateness of PC transfusions.
• E-learning and system modifications support a more restrictive approach to PC transfusions.
• The program's success was demonstrated by increased appropriateness and a shift towards more therapeutic transfusions.