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Contributions

Computer-assisted audits of blood component transfusion

Gerald A. Hoeltge, MD, Juanita C. Brown, RN, Roger H. Herzig, MD, M. Regina Johannisson, CCRN, Bruce L. Millward, MA, Patrick J. O’Hara, MD, James P. Orlowski, MD, David E. Sharp, MD, PHD and Andrew M. Zurick, MD
Cleveland Clinic Journal of Medicine May 1989, 56 (3) 267-272;
Gerald A. Hoeltge
Department of Blood Banking, The Cleveland Clinic Foundation
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Juanita C. Brown
Division of Nursing, The Cleveland Clinic Foundation
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Roger H. Herzig
Department of Hematology and Medical Oncology, The Cleveland Clinic Foundation
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M. Regina Johannisson
Division of Nursing, The Cleveland Clinic Foundation
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Bruce L. Millward
Department of Blood Banking, The Cleveland Clinic Foundation
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Patrick J. O’Hara
Department of Vascular Surgery, The Cleveland Clinic Foundation
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James P. Orlowski
Department of Pediatrics, The Cleveland Clinic Foundation
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David E. Sharp
Department of Blood Banking, The Cleveland Clinic Foundation
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Andrew M. Zurick
Department of Cardiothoracic Anesthesiology, The Cleveland Clinic Foundation
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ABSTRACT

Comprehensive review of clinical blood transfusion practice at a tertiary-care medical center is complicated by the extraordinary number of patients that receive such therapy. Computer-assisted review of the key objective data used in making the decisions about transfusion is necessary to evaluate the process. Use of 15,873 units of red blood cells, 3,641 units of plasma, 2,619 pools of platelets or pheresis units, and 259 pools of cryoprecipitate was screened by comparing pre-transfusion and post-transfusion blood counts with the medical staff’s evaluation criteria. On this basis, 81.4% of transfusion episodes (TEs) were considered fully justified. Medical records were selected for audit from the cases in which the transfusion decisions could not be justified by on-line information. Abstracted data subsequently justified 82 of 139 audited cases; 68.4% of the comments pertaining to the remaining 57 cases adequately explained the transfusion decision. Thus, nearly 9 6 % of the TEs were justifiable as determined by peer review.

INDEX TERMS
  • Algorithms
  • Blood Transfusion
  • Medical Audit
  • Professional Staff Committees
  • Quality Assurance
  • Health Care
  • Utilization Review
  • Received May 1988.
  • Accepted October 1988.
  • Copyright © 1989 The Cleveland Clinic Foundation. All Rights Reserved.
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Cleveland Clinic Journal of Medicine: 56 (3)
Cleveland Clinic Journal of Medicine
Vol. 56, Issue 3
1 May 1989
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Computer-assisted audits of blood component transfusion
Gerald A. Hoeltge, Juanita C. Brown, Roger H. Herzig, M. Regina Johannisson, Bruce L. Millward, Patrick J. O’Hara, James P. Orlowski, David E. Sharp, Andrew M. Zurick
Cleveland Clinic Journal of Medicine May 1989, 56 (3) 267-272;

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Computer-assisted audits of blood component transfusion
Gerald A. Hoeltge, Juanita C. Brown, Roger H. Herzig, M. Regina Johannisson, Bruce L. Millward, Patrick J. O’Hara, James P. Orlowski, David E. Sharp, Andrew M. Zurick
Cleveland Clinic Journal of Medicine May 1989, 56 (3) 267-272;
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Keywords

  • Algorithms
  • Blood Transfusion
  • Medical Audit
  • Professional Staff Committees
  • Quality Assurance
  • Health Care
  • Utilization Review

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