Blood transfusion can save lives, but every transfusion carries risks. The Ontario Transfusion Quality Improvement Plan (OTQIP) for red blood cell transfusion can help determine your hospital’s baseline performance, measure how well your hospital uses RBCs for patients and identify where your hospital can make improvements.
Successful quality improvement requires a multi-disciplinary team approach: physicians, nurses and nurse practitioners and laboratory technologists, much like the composition of the the OTQIP Committee that developed the plan in the first place. It was a truly cooperative team effort with multi-disciplinary representatives from the Ontario Regional Blood Coordinating Network (ORBCoN), Ontario Nurse Transfusion Coordinators (ONTraC), Canadian Blood Services and transfusion community members.
This plan supports a more restrictive approach to RBC transfusion for stable, non-bleeding patients by looking at threshold hemoglobin levels, and by measuring how often just one bag of blood is transfused at a time (the single unit transfusion).
The OTQIP provides tools that will aid in improving transfusion practice including:
- Transfusion guidelines
- Blood order sets
- Guidance/educational tools to promote medical laboratory technologist prospective screening for transfusion orders
- An e-tool to aid data collection and comparative analysis
- A model example of a quality improvement plan (QIP) that can be modified for your institution
In addition to alignment with the Choosing Wisely Canada campaign, the OTQIP is similar to other national and provincial quality improvement plans like Health Quality Ontario, which focus on patient safety and health care system efficiency. The plan also aligns with Health Service Accountability Agreements, Accreditation Canada, and the Institute for Quality Management in Healthcare.
ORBCoN liaised with other transfusion and quality-related organizations such as Canadian Blood Services, hospital transfusion services, the Healthcare Insurance Reciprocal of Canada (HIROC), Health Quality Ontario and the Canadian Society for Transfusion Medicine to disseminate the plan.
How can you get started?
- Determine your baseline
- Spread the word through screen savers, Transfusion Committee, Medical Advisory, Safety and Quality Committees
- Educate: physicians, nurses and medical laboratory technologists
- Establish transfusion guidelines and order sets
- Implement front line blood order screening by medical laboratory technologists
- Measure and analyze
- Collect data, share results, tweak and celebrate