A multifaceted intervention to optimize red blood cell transfusion practice in two provinces

People receive red blood cell (RBC) transfusions for many reasons including surgery, injury, cancer, bleeding and being treated for diseases of the blood. A RBC transfusion is the most common procedure performed in the hospitalized patient, with ten percent of hospitalized patients being transfused. The decision to transfuse RBCs is based on a number of factors such as the amount of hemoglobin in your blood, amount of blood loss, your clinical condition and whether you have heart disease. Often however, physicians transfuse patients based solely on the laboratory test results, without taking into account individual patient factors. There is a growing awareness that RBC transfusion is an overused treatment, with as many as 1 in 5 Ontario transfusions being unnecessary. Unnecessary transfusions result in poor patient outcomes and increased hospital costs. The goal of this quality improvement project is to achieve 90% appropriateness of RBC transfusion in 18 hospitals across Ontario and Alberta over a period of two years. In order to achieve this, we will carry out an intervention which includes implementing RBC transfusion hospital guidelines, focused education of nurses and doctors, medical laboratory technologist screening of transfusion orders, and monthly feedback to ordering physicians regarding unnecessary transfusions.

WEBERT, Kathryn

McMaster University

Intramural Research Grant Program

Ontario

$332,942