A QUALITY IMPROVEMENT TEAM ON AUTOLOGOUS AND DIRECTED-DONOR BLOOD AVAILABILITY

Background: Until 1985, volunteer donors provided blood for almost all transfusions and donated blood was rarely restricted for transfusion to a specific patient. With the AIDS (Acquired Immunodeficiency Syndro me) crisis, autologous (blood from oneself) and directed (blood from f amilies and friends) donations increased, calling for handling of far greater complexity. At the University of California at San Francisco M edical Center, the demand for special donations superseded the develop ment of systems to meet the demand and autologous and/or directed dona tions were often not available when needed. After a rapid rise in inci dent reports and complaints from physicians, nurses, patients, and fam ilies, a quality improvement (QI) team was formed in mid-1991 to impro ve blood availability. Method: Meetings were held to analyze the proce sses involved In blood donation and transfusion, identify and categori ze problems, develop interventions, test and implement solutions, and monitor improvements. Educational efforts were implemented throughout the medical center, recruitment for a special donations coordinator be gan, and changes were made in the blood bank's internal systems. Resul ts: In two years, with stable numbers of transfused units, the number of incident reports regarding blood availability decreased from 19 to 2 per year-an improvement that has been sustained for more than three years. The QI team continues to meet regularly to design and implement additional improvements. Conclusion: A QI team has improved the avail ability of autologous and directed-donor blood to patients and has ext ended the impact of the QI methodology throughout the medical center a s a whole.