Clinical trial NCT04823273: Blood Transfusion Reduction - QI Project
Official title: Blood Transfusion Reduction Quality Improvement Project
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Blood Transfusion
Keywords: blood transfusion
EHR interventions
user-centered design
high-value care
Lead sponsor: University of Colorado, Denver
Sponsor class: OTHER
First posted: 2021-03-30
Enrollment: 1640
Sex: ALL
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: HEALTH_SERVICES_RESEARCH

Brief summary: Blood Banks of large medical centers have large annual budgets, typically millions of dollars. Blood product wastage results in not only in a loss of the product's cost, but also of the fees involved in transporting, handling, and administering these products. Optimal utilization of blood products requires a balance between maximizing patient clinical outcomes while avoiding unnecessary costs and risks associated with transfusions. This project will specifically focus on packed red blood cell transfusions (pRBCs). There are clear guidelines for transfusing pRBCs however these guidelines are not always followed. pRBC transfusions outside of recommended guidelines is associated with increased risk of harm to patients.

Our aim is to improve adherence to guideline indicated pRBC transfusions for patient in the UCHealth system thereby decreasing inappropriate (non-guideline indicated) pRBC transfusions. We will conduct a QI project seeking to improve pRBC transfusion guideline adherence. This project will involve data review to establish baseline rates, multimodal interventions to improve adherence to pRBC transfusion guidelines including provider education, modifications to the electronic ordering interface, and changing blood back policies at participating institutions.


Eligibility criteria: Inclusion Criteria:

* All physicians and nurses with access to order inpatient blood transfusions through a hospital-based EMR.
* All physicians and nurses ordering blood for individuals over the age of 18.

Exclusion Criteria:

* All physicians and nurses ordering blood transfusion ordering blood in the OR
* Blood ordered through massive transfusion protocol

Primary outcomes:
measure: Blood Transfusion Orders
timeFrame: 78 weeks
measure: Guideline Concordance Measured by Pre-Transfusion Hemoglobin Values Per Transfusion
timeFrame: 78 weeks
measure: Guideline Concordance Measured by Number of Units Ordered Per Transfusion
timeFrame: 78 weeks
Secondary outcomes:
Other outcomes:
measure: Historical Blood Transfusion Orders
timeFrame: Baseline
measure: Historical Guideline Concordance Measured by Pre-Transfusion Hemoglobin Values Per Transfusion
timeFrame: Baseline
measure: Guideline Concordance Measured by Number of Units Ordered Per Transfusion
timeFrame: Baseline
Locations:
city: Aurora
country: United States
facility: UCHealth University of Colorado Hospital
state: Colorado
Study officials:
affiliation: University of Colorado Denver Anschutz Medical Campus
name: Michael Ho, MD, PhD
role: STUDY_DIRECTOR
affiliation: University of Colorado Denver Anschutz Medical Campus
name: Tyler Anstett, DO
role: PRINCIPAL_INVESTIGATOR
References: