effective transfusion committee

[Mabel Adams]

My Lab Director has tasked me with finding a peer hospital that has an effective Transfusion Committee so that we can copy what works. We are looking at representation, scope, meeting formats etc. Any other US community hospital of, say, 150-450 beds with a functional transfusion committee out there that is willing to share what works for them?

[EMB4879]

I would like to know how to get more people involved. We had one meeting were it was myself, my supervisor, and out medical director....no one else came. I dont know when the last time we actually had physicians on board. We do have the nursing educator come, but that is about all of our "steady" attendees!

[AMcCord]

I would like to know how to get more people involved. We had one meeting were it was myself, my supervisor, and out medical director....no one else came. I dont know when the last time we actually had physicians on board. We do have the nursing educator come, but that is about all of our "steady" attendees!

Common problem I suspect. We almost always get the chair of the committee to attend (which rotates through the medical staff and could be an opthamologist or other specialist who never uses blood products), but the few physicians who seem willing to come are NOT the big blood users. Can never get an ortho to attend.

[Bill]

One hospital that I worked at with this problem merged the Transfusion Committee with the Medical Staff Utilaztion(sp) Review Committee. The blood bank and nursing people attended the beginning of meeting with the transfusion business and left so the medical staff finished all the other UR stuff. Not much time to talk procedures, supply, vendor, etc issues, but the MD's did get involved with unnecessary transfusions better. We later added a subcommittee for all the non-UR issues to better address those issues.

[tbostock]

Couple things that have worked for us:

1. Instead of assigning specific physicians to the committee, we sent the VP a list of divisions that we felt needed to be present (ortho, hem/onc, ER, gen surg, etc). We asked him to appoint a member from each. Then we send the invitation to the meeting, and the rule is: if you can't come, you MUST send another rep from your division.

2. Now that we have an EMR, we took chart review (mostly) away from the committee. I preview all transfusions to see if they met our transfusion criteria. If not, then my Medical Director reviews them and scours the EMR for more info. If he still thinks it may not be justified, then it goes to committee. The number of charts we look at are greatly reduced, leaving us time to discuss other topics.

3. We now have a room with a laptop/projector so we can look at data, etc, and look up patients in the EMR to discuss as a group. Going paperless has been helpful; the docs say the meetings aren't as "boring" as just reading through a bunch of paper reports.

4. We commit to having the meeting end at exactly an hour. We start at 0730 and are done by 0830 so they can get back to their offices.

At the meeting we review: statistics (#transfused, expired, wasted units. C/T ratios, workload), transfusion reactions, serious events, inspections, proficiency results, autotransfusions, nuclear med reinfusion procedures, vendor issues, new policies, quality indicators, Joint Commission performance measures, new business.