Quality management in the transfusion service: case studies in process improvement

Abstract

Successful QI in the TS improves processes that promote efficiency, effectiveness, and patient safety.

A novel approach to improving efficiency and cost saving in preoperative blood preparation

“…After the storage interval was increased to 14 days, the median number of exT&Ss performed increased by a median of 37 samples per month (range, 25‐61), with no significant change in surgical volume per month. Assuming a T&S charge is between $75 and $100 with a median of $87.50, potential savings totaled $38,770 per year ($22,420‐$73,120). Further varying monthly volumes by decreasing the number of redrawn specimens by 50% to 75% still showed annual savings with a range from $11,170 to $54,820 (Table , Fig.…”

“…Proceeding before completion of T&S testing can lead to up to a 12‐hour delay before starting surgery or worse if surgery is started and blood is not available. Due to compromised patient safety, some institutions have incorporated the T&S status into their surgical safety checklist . Consequently, it is of particular importance to the anesthesiologist and surgeon to have a completed T&S before induction of anesthesia.…”

Education‐based interventions to minimize sampling errors in transfusion

“…Interventions implemented by transfusion services in the UK and USA have included banning of addressograph labels, confirmatory ABO typing, education programmes and electronic transfusion systems . The impact of a dedicated phlebotomy service on sampling errors was highlighted in a study of 147 laboratories where those with a dedicated phlebotomy service had 1·1 errors per 1000 specimens while those without one had 2·7 errors per 1000 specimens .…”

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

“…Blood banks must supply prompt and reliable blood services for providers and their patients through quality management 14,15 . Benchmark targets for blood banks have been successfully implemented by several countries to monitor a wide range of quality assurance and quality improvement variables.…”