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OpenTrials
Completed

NCT Number: NCT04823273

Blood Transfusion Reduction - QI Project

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.

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Key information

Conditions

Blood Transfusion

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

UCHealth University of Colorado Hospital

Aurora, Colorado, 80045, United States

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

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

Treatment and study plan

General improvement

Behavioral

Changes to interface to be more intuitive.

In-line help text

Behavioral

General improvement + in-line help text

Interruptive alert

Behavioral

General improvement + interruptive alert

Primary outcomes

  1. Blood Transfusion Orders

    Time frame: 78 weeks

    Number of patients who received blood transfusions during the study by arm.

  2. Guideline Concordance Measured by Pre-Transfusion Hemoglobin Values Per Transfusion

    Time frame: 78 weeks

    The American Association of Blood Banks recommends a restrictive threshold of a pre-transfusion hemoglobin level of less than 7.0g/dL for the vast majority of inpatients. Transfusions with Hemoglobin levels above 7 will be compared in arm 1 vs 2 +3 combined; arm 2 vs arm 3.

  3. Guideline Concordance Measured by Number of Units Ordered Per Transfusion

    Time frame: 78 weeks

    The American Association of Blood Banks recommends a restrictive threshold of a single unit pRBC transfusion for the vast majority of inpatients. This outcome will compare hemoglobin levels, units transfused in arm 1 verses arms 2 and 3 combined and arm 2 verses arm 3.

Other outcomes

  1. Historical Blood Transfusion Orders

    Time frame: Baseline

    Number of patients who received blood transfusions during the 18 months prior to study start in the EHR at the same hospital.

  2. Historical Guideline Concordance Measured by Pre-Transfusion Hemoglobin Values Per Transfusion

    Time frame: Baseline

    The American Association of Blood Banks recommends a restrictive threshold of a pre-transfusion hemoglobin level of less than 7.0g/dL for the vast majority of inpatients. Historical data for 18 months prior to study start will be collected from EHR records for transfusions orders placed for patients with Hemoglobin levels above 7.

  3. Guideline Concordance Measured by Number of Units Ordered Per Transfusion

    Time frame: Baseline

    The American Association of Blood Banks recommends a restrictive threshold of a single unit pRBC transfusion for the vast majority of inpatients. Historical data for 18 months prior to study start will be collected from EHR records for the number of units transfused per blood transfusion order.

Sponsors and collaborators

Lead sponsor

University of Colorado, Denver

Other

Registry information

Official study title

Blood Transfusion Reduction Quality Improvement Project

Important dates

Study start
2021
Primary completion
2022
Study completion
2022
First posted
Mar 30, 2021
Registry last updated
May 10, 2023

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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