智慧地使用血液:通过制定国家实施方案来减少不适当的红细胞输血,我们吸取了教训
Yulia Lin1,2, Wendy Levinson3,4, Doreen Day3
1Precision Diagnostics and Therapeutics Program, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada Yulia.Lin@sunnybrook.ca.
BMJ open quality
|April 3, 2024
概括
"明智地使用血液"计划成功地让许多加拿大医院致力于改善红细胞输血实践. 这项质量改进倡议在满足输血基准方面表现出了显著的参与和初步成功.
科学领域:
- 改善医疗保健质量 改善医疗保健质量
- 输血医学 输血医学
- 患者安全 患者安全
背景情况:
- 尽管有基于证据的指导方针,但高达50%的输血是不适当的.
- 选择明智加拿大于2020年启动了"明智地使用血液"计划,以解决不适当使用红细胞输血的问题.
- 该计划旨在让医院与国家基准对输血实践进行审计.
研究的目的:
- 评估"明智地使用血液"质量改进计划的参与和初始结果.
- 评估医院参与审计和改善红细胞输血实践.
- 识别项目实施过程中遇到的障碍.
主要方法:
- "明智地使用血液"计划利用了国家基准,审计工具和基于证据的干预措施.
- 医院的参与度以报名,审计完成,调查提交和指定成就来衡量.
- 从参与的医院系统地收集实施障碍的信息.
主要成果:
- 229家医院 (159个组) 代表了加拿大72%的血液使用.
- 92%完成了基线审计,82%参加了多次审计.
- 51%的人在基线达到基准,39%的人取得了持续成功的指标.
结论:
- "明智地使用血液"计划实现了医院在输血质量改善方面的实质性和持续参与.
- 这项大规模的国家倡议在最初阶段超出了人们的预期.
- 需要进一步严格评估,以确定该计划对输血利用的影响.
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