Table 1.

Quality Indicators that might impact on the risk of adverse patient events and some suggestions regarding tracking data (list not exhaustive).

  • Patient identifiers: Track occurrence of pre-transfusion blood specimens that are submitted for testing but which are labeled with fewer than two unique patient identifiers.

  • Multiple records: Track occurrence of patients who have more than one unique medical record assigned to them (i.e., patient has more than one medical chart number).

  • Anomalous test results: Track occurrence of patients who have discordant ABO and/or Rh test results when comparing current results with historical records.

  • Antibody detection testing: Track occurrence of patients for whom there is a change in the status of unexpected antibody detection testing from negative to positive and/or patients whose antibody detection testing increases in strength.

  • Transfusion reactions: Track transfusion reactions by category, implicated products, clinical services, and work shifts.

  • Transfusion service laboratory errors and noncompliance with established procedures: Track all technical errors, clerical errors, and use of non-validated techniques or equipment.

  • Biological product deviations (BPDs) and fatalities associated with transfusion: Track all BPDs and transfusion fatalities. (These events must also be reported to the FDA.)29,30 

  • Blood bank computing system transactions: Track occurrence of errors made by the computing system and/or the failure of laboratory personnel to react properly to computer alert messages.

  • Merging records: Track the occurrence of merging or linking duplicate patient records and determine if an audit trail can provide full patient details of both records prior to merging/linking, as well as the date/time of the merge/link, and the name of the individual authorizing the merge/link

  • Turn around times (TAT) for provision of blood and components: Track the TAT for issuance of each blood product category by clinical indication. For example, what is the measured TAT for issuance of blood to surgery for a patient with an in date Type and Screen specimen that shows no unexpected red cell antibodies? What is the measured TAT for issuance of blood to the emergency room for a patient in dire need of RBC transfusions?

 

  • Patient identifiers: Track occurrence of pre-transfusion blood specimens that are submitted for testing but which are labeled with fewer than two unique patient identifiers.

  • Multiple records: Track occurrence of patients who have more than one unique medical record assigned to them (i.e., patient has more than one medical chart number).

  • Anomalous test results: Track occurrence of patients who have discordant ABO and/or Rh test results when comparing current results with historical records.

  • Antibody detection testing: Track occurrence of patients for whom there is a change in the status of unexpected antibody detection testing from negative to positive and/or patients whose antibody detection testing increases in strength.

  • Transfusion reactions: Track transfusion reactions by category, implicated products, clinical services, and work shifts.

  • Transfusion service laboratory errors and noncompliance with established procedures: Track all technical errors, clerical errors, and use of non-validated techniques or equipment.

  • Biological product deviations (BPDs) and fatalities associated with transfusion: Track all BPDs and transfusion fatalities. (These events must also be reported to the FDA.)29,30 

  • Blood bank computing system transactions: Track occurrence of errors made by the computing system and/or the failure of laboratory personnel to react properly to computer alert messages.

  • Merging records: Track the occurrence of merging or linking duplicate patient records and determine if an audit trail can provide full patient details of both records prior to merging/linking, as well as the date/time of the merge/link, and the name of the individual authorizing the merge/link

  • Turn around times (TAT) for provision of blood and components: Track the TAT for issuance of each blood product category by clinical indication. For example, what is the measured TAT for issuance of blood to surgery for a patient with an in date Type and Screen specimen that shows no unexpected red cell antibodies? What is the measured TAT for issuance of blood to the emergency room for a patient in dire need of RBC transfusions?

 
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