Improving transfusion practices in a busy teaching hospital

Area of Science:

• Transfusion Medicine
• Healthcare Management
• Clinical Audit

Background:

• High crossmatch/transfusion (C/T) ratios indicate inefficient blood utilization in hospitals.
• Cardiff Royal Infirmary (CRI) identified excessive C/T ratios across clinical directorates.
• Optimizing blood transfusion practices is crucial for resource management and patient care.

Purpose of the Study:

• To evaluate the efficiency of blood request and usage by clinical directorates at CRI.
• To implement and assess revised blood transfusion guidelines in collaboration with the Orthopaedic Directorate.
• To determine the impact of inter-departmental audit on blood transfusion practices and resource allocation.

Main Methods:

• A retrospective audit of blood transfusions was conducted at CRI.
• A pilot study involved the Department of Haematology and the Orthopaedic Directorate.
• Guidelines were revised based on a preliminary audit, emphasizing group and antibody screen (G & S) for low-risk procedures.
• A subsequent prospective audit evaluated the revised guidelines' effectiveness.

Main Results:

• Revised guidelines led to major reductions in crossmatch requests.
• C/T ratios decreased significantly to efficient levels.
• No patient morbidity was associated with the changes.
• Blood availability for urgent cases improved, alongside substantial cost savings.

Conclusions:

• Inter-departmental audit, exemplified by the orthopaedic surgery department, is valuable for improving transfusion efficiency.
• Revised crossmatch guidelines based on risk assessment can optimize blood usage.
• Implementing such strategies can lead to considerable savings and better resource management in healthcare settings.