Blood ordering from the operating room: turnaround time as a quality indicator

McClain, Colt M.; Hughes, Jonathan; Andrews, Jennifer; Blackburn, J.P.; Sephel, Stephanie; Viele, Maurene; Goodnough, Lawrence T.; Young, Pampee P.

doi:10.1111/j.1537-2995.2012.03670.x

Cited by 13 publications

(10 citation statements)

References 17 publications

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“…The 8-min timeline for a blood issue was comparable with the other studies, which found an issue TAT of 6–21 min. [1315] The authors believe that due to the gravity of the task (final check before release), there is hardly any scope for further reducing this time. Irrespective of whether a manual or an automated system was used, the issue time has averaged around 5–7 min in most of the studies.…”

Section: Discussionmentioning

confidence: 99%

Turnaround time for red blood cell transfusion in the hospitalized patient: A single-center “Blood Ordering, Requisitioning, Blood Bank, Issue (of Blood), and Transfusion Delay” study

Agnihotri¹,

Agnihotri²

2018

Indian Journal of Critical Care Medicine

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Background and Aim:The turnaround time (TAT) for blood transfusion (BT) is an important quality indicator for the health-care institutions undertaking this procedure. There is no established national or international benchmark for this TAT due to the dearth of a published literature. We thus studied the TAT and the contributory procedures leading to delay in commencing a red blood cell transfusion in the hospitalized patient.Materials and Methods:Delay was captured for the blood order transcription, requisitioning and sampling by the nurse, blood bank (BB) processing, blood issue, and the transfusion commencement in the hospitalized patients. The study was done prospectively over a 1-year period and involved all the patient locations spread over six floors in a tertiary care accredited hospital.Results:A total of 2022 blood requests were analyzed during the study period. Most (73%) of the blood requests were marked as urgent by the treating unit. The average time from ordering to initiation of BT was 135 min in our study. BB processes (compatibility testing and issue) comprised approximately 47% of this delay (63 min), while rest of the delay happened in the processes (ordering 13 min, sample transport 34 min, and BT commencement 25 min) outside the BB (72 min).Conclusion:Majority of the delay for blood transfusion happens due to the processes outside blood bank premises. Understanding the steps where delay happens has the potential to reduce the turnaround time for lifesaving procedures such as blood transfusion in the hospitalized patients.

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Section: Discussionmentioning

confidence: 99%

Turnaround time for red blood cell transfusion in the hospitalized patient: A single-center “Blood Ordering, Requisitioning, Blood Bank, Issue (of Blood), and Transfusion Delay” study

Agnihotri¹,

Agnihotri²

2018

Indian Journal of Critical Care Medicine

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“…This aspect should be contemplated by the protocol algorithm of each hospital center. 1,2,42,43 The use of MOH protocols has been shown to be useful for facilitating rapid transfusion of a sufficient volume of blood products, and such protocols are also cost-effective (lesser general use of products). Massive obstetric hemorrhage protocols moreover improve the communication lines referred to the request for transfusion and transport from the blood bank to the place where the blood is needed.…”

Section: Massive Transfusion Protocols In Mohmentioning

confidence: 99%

Massive obstetric hemorrhage: Current approach to management

Guasch

Gilsanz

2016

Medicina Intensiva (English Edition)

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“…The time table for issuing blood emergently depends on whether type-specific, crossmatched RBC can be provided within an acceptable turnaround time[28], based on the diagnostic antibody screen results (Table 1). We have developed a standardized MTP for women with an emergent need for blood transfusion, including those whose antibody screen evaluation was positive or unknown upon admission.…”

Section: Massive Transfusion Protocol For Postpartum Hemorrhagementioning

confidence: 99%

Transfusion and coagulation management in major obstetric hemorrhage

Butwick¹,

Goodnough

2015

Current Opinion in Anaesthesiology

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103

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Purpose of Review Major obstetric hemorrhage is a leading cause of maternal morbidity and mortality. We will review transfusion strategies and the value of monitoring the maternal coagulation profile during severe obstetric hemorrhage. Recent Findings Epidemiologic studies indicate that rates of severe postpartum hemorrhage (PPH) in well-resourced countries are increasing. Despite these increases, rates of transfusion in obstetrics are low (0.9% - 2.3%), and investigators have questioned whether a pre-delivery ‘type and screen’ is cost-effective for all obstetric patients. Instead, blood ordering protocols specific to obstetric patients can reduce unnecessary antibody testing. When severe PPH occurs, a massive transfusion protocol (MTP) has attracted interest as a key therapeutic resource by ensuring sustained availability of blood products to the labor and delivery unit. During early postpartum bleeding, recent studies have shown that hypofibrinogenemia is an important predictor for the later development of severe PPH. Point-of-care technologies, such as thromboelastography and rotational thromboelastometry, can identify decreased fibrin-clot quality during PPH, which correlate with low fibrinogen levels. Summary A MTP provides a key resource in the management of severe PPH. However, future studies are needed to assess whether formula driven vs. goal-directed transfusion therapy improves maternal outcomes in women with severe PPH.

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Blood ordering from the operating room: turnaround time as a quality indicator

Abstract: Many of the surveyed institutions do not monitor stat RBC issue TAT as a quality indicator. This study serves as a starting point for establishing a benchmark for TAT for issuing RBCs from the blood bank to ORs.

Cited by 13 publications

References 17 publications

Turnaround time for red blood cell transfusion in the hospitalized patient: A single-center “Blood Ordering, Requisitioning, Blood Bank, Issue (of Blood), and Transfusion Delay” study

Turnaround time for red blood cell transfusion in the hospitalized patient: A single-center “Blood Ordering, Requisitioning, Blood Bank, Issue (of Blood), and Transfusion Delay” study

Massive obstetric hemorrhage: Current approach to management

Transfusion and coagulation management in major obstetric hemorrhage

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