Redesigning Blood Transfusion Services: A Process Excellence Tools-Driven Quality Improvement Initiative

Delays in blood component processing strain transfusion services and may harm patients. This study evaluated the impact of structured process excellence tools on operational efficiency, delay incidence and quality indicators at a tertiary care blood centre.

Prospective pre-post quality improvement study (July 2024 to December 2025). Consecutive inclusion yielded 1,494 episodes (747 in-hospital blood requests and 747 donor encounters). Phase I established baseline parameters; Phase II applied Lean Six Sigma DMAIC, Root Cause Analysis (RCA), Corrective and Preventive Action (CAPA) and the Plan-Do-Check-Act (PDCA) cycle; Phase III re-measured identical parameters. Welch's t-test and chi-square tests were used; p<0.05 was considered significant.

Issue/reserve turnaround time decreased from 48.3 ± 20.9 to 19.8 ± 4.5 minutes (-59.0%, p<0.001). Donor waiting time decreased from 50.6 ± 9.8 to 28.5 ± 2.7 minutes (-43.7%, p<0.001). Delay incidence decreased across all five categories (p<0.001). Wastage rate decreased from 0.83% to 0.34% and component QC failure from 0.92% to 0%. Incidents decreased from 75 to 29 (p<0.001). Transfusion-transmitted infection rate was unchanged. The C/T ratio remained below the conventionally used utilisation benchmark of 2.5 in both phases (1.85 before intervention and 1.84 after intervention).

A structured, multi-component quality-improvement programme developed using common process excellence tools was associated with improved operational efficiency, reduced delays, and better selected quality indicators in a tertiary-care blood centre. Controlled and multicentre studies incorporating inventory and blood-group-specific measures are required to evaluate sustainability and wider applicability.