Rush University Medical Center Chicago, Illinois, United States
Background/Case Studies: Various definitions of massive transfusion (MT) exist, highlighting that MT can be broadly characterized in multiple ways, but no single definition comprehensively covers all clinical scenarios. The variability in clinical requirements during MT makes assigning a perfectly defined protocol unrealistic, often leading to the unavoidable wastage of blood products, communication breakdowns, and departmental silos. To address these challenges, a multidisciplinary team at a large urban academic medical center implemented a web-based tracking tool to monitor waste, manage communication concerns, and provide uniformity through standardization of the MT process across departments. This study evaluates the tool's process and effectiveness.
Study
Design/Methods: The tool systematically tracked metrics for each Massive Transfusion Protocol (MTP) released by the blood bank. These metrics included patient demographics, location, date and time of activation, blood product allocation, length of preparation time, and communication barriers. Data was collected by blood bank professionals in near real time and analyzed during monthly debriefing meetings with a multidisciplinary MTP committee consisting of both nursing and blood bank teams to formalize action plans.
Implemented in April 2023, the study included 58 patients (33 male/25 female) aged 18 to 90, excluding individuals under 17. Patient demographics recorded were name and medical record number, with additional data collection including gender and age through concurrent and retrospective electronic medical records.
Results/Findings: Pre-implementation data preceding the activation of the tracking tool was compared with data from April 2023 to March 2024 to determine the tool’s impact across various hospital areas including the Emergency Department, Adult ICUs, Operating Rooms, and Labor & Delivery. See Figure 1. With a target success rate of 10% or less, wastage was maintained at 7% post-implementation, which was within an acceptable range. Reviews of each MTP revealed a progressive reduction in communication barriers throughout the tool's application with a negative slope. Overall, blood product wastage declined by 18% and miscommunication by 35% throughout this study period. Conclusions: The results confirmed that an interactive MTP tracking tool improved outcomes regarding waste monitoring and communication concerns in real time across multiple departments, demonstrating its utility as a valuable resource for other blood banks seeking to enhance MTP tracking in these areas.
