Using Quality Improvement to Optimize Blood Product Utilization in a Pediatric Cardiac Catheterization Laboratory

Abstract

Abstract Packed red blood cells (PRBC) are frequently ordered for cardiac catheterization procedures, which increases resource utilization and patient charges. We created a quality improvement project focused on optimizing ordering of PRBC for pediatric cardiac procedures. Our primary aim was to increase adherence to ordering guidelines to greater than 97%, with a global aim to decrease patient cost by reducing associated charges. The existing blood product ordering guidelines were revised and procedure reports were updated to include administration of blood products. Appropriate measures were tracked to monitor the rate of pre-procedure PRBC orders, adherence to the new protocol guidelines, verify appropriate documentation and monitor the rate of blood transfusion within 24 hours post-procedure as well as incidence of emergency release blood during a procedure. During our study period, there was a statistically significant process change from a median of 86–100% adherence (p = 0.01) since implementation of the updated guidelines. With improved adherence, we decreased the use of hospital resources and charges to the patient in low-risk cardiac catheterization procedures, without an increase in adverse events.