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Amon CC, Paley AR, Forbes JA, Guzman LV, Rajwani AA, Trzcinka A, Comenzo RL, Drzymalski DM. Implementing structured handoffs to verify operating room blood delivery using a quality academy training program: an interrupted time-series analysis. Int J Qual Health Care 2021; 33:6213818. [PMID: 33825860 DOI: 10.1093/intqhc/mzab061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 03/02/2021] [Accepted: 04/06/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Blood transfusion is a complex process at risk for error. OBJECTIVE To implement a structured handoff during the blood transfusion process to improve delivery verification. METHODS A multidisciplinary team participated in the quality academy training program at an academic medical center and implemented a structured handoff of blood delivery to the operating room (OR) using Plan-Do-Study-Act cycles between 28 October 2019 and 1 December 2019. An interrupted time-series analysis was performed to investigate the proportions of verified deliveries (primary outcome) and of verified deliveries among those without a handoff (secondary outcome). Delivery duration was also assessed. RESULTS A total of 2606 deliveries occurred from 1 July 2019 to 19 April 2020. The baseline trend for verified deliveries was unchanging [parameter coefficient -0.0004; 95% confidence interval (CI) -0.002 to 0.001; P = 0.623]. Following intervention, there was an immediate level change (parameter coefficient 0.115; 95% CI 0.053 to 0.176; P = 0.001) without slope change (parameter coefficient 0.002; 95% CI -0.004 to 0.007; P = 0.559). For the secondary outcome, there was no immediate level change (parameter coefficient -0.039; 95% CI -0.159 to 0.081; P = 0.503) or slope change (parameter coefficient 0.002; 95% CI -0.022 to 0.025; P = 0.866). The mean (SD) delivery duration during the intervention was 12.4 (2.8) min and during the post-intervention period was 9.6 (1.6) min (mean difference 2.8; 95% CI 0.9 to 4.8; P = 0.008). CONCLUSION Using the quality academy framework supported the implementation of a structured handoff during blood delivery to the OR, resulting in a significant increase in verified deliveries.
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Affiliation(s)
- Carly C Amon
- Tufts University School of Medicine, 145 Harrison Ave, Boston, MA 02111, USA
| | - Adina R Paley
- Tufts University School of Medicine, 145 Harrison Ave, Boston, MA 02111, USA
| | - Judith A Forbes
- Department of Pathology and Laboratory Medicine, Tufts Medical Center, 800 Washington St, Boston, MA 02111, USA
| | - Leidy V Guzman
- Department of Quality and Patient Safety, Tufts Medical Center, 800 Washington St, Boston, MA 02111, USA
| | - Aliysa A Rajwani
- Department of Quality and Patient Safety, Tufts Medical Center, 800 Washington St, Boston, MA 02111, USA
| | - Agnieszka Trzcinka
- Tufts University School of Medicine, 145 Harrison Ave, Boston, MA 02111, USA.,Department of Anesthesiology and Perioperative Medicine, Tufts Medical Center, 800 Washington St #298 Ziskind Building, 6th Floor, Boston, MA 02111, USA
| | - Raymond L Comenzo
- Tufts University School of Medicine, 145 Harrison Ave, Boston, MA 02111, USA.,Department of Pathology and Laboratory Medicine, Tufts Medical Center, 800 Washington St, Boston, MA 02111, USA
| | - Dan M Drzymalski
- Tufts University School of Medicine, 145 Harrison Ave, Boston, MA 02111, USA.,Department of Anesthesiology and Perioperative Medicine, Tufts Medical Center, 800 Washington St #298 Ziskind Building, 6th Floor, Boston, MA 02111, USA
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