In Focus

Quality Indicators in Blood Establishments

Historical Overview and New Developments

Tomislav Vuk

Croatian Institute of Transfusion Medicine, Zagreb, Croatia Read bio >

Ensuring the quality and safety of blood components for transfusion is the fundamental goal of blood establishments.

It is achieved through numerous processes that are highly regulated and supported by a quality system based on good practice and quality risk management. Quality monitoring is one of the key segments of the quality system and is closely related to the strategy of quality improvement. It enables insight into the level of fulfillment of requirements, identification of risks and opportunities for improvement 1.

Quality improvement efforts rely heavily on available data and how we use it to select improvement strategies. Processes in blood establishments generate a large amount of different data. These data differ according to their source, significance, and purpose. Identification of data that enables insight into the level of quality of products and services, their analysis, interpretation, and appropriate actions based on them, are necessary in the process of quality improvement.

Quality indicators play a significant role in achieving these goals. Their use in the field of transfusion medicine has been supported by the ISBT Working Party on Quality Management (WP-QM) for years. The first activities started in 2010 with the proposal of an international approach in the selection and promotion of the use of quality indicators in blood establishments and hospital blood banks. Presentations at ISBT congresses and publications on this topic further contributed to the sharing of information, knowledge, and experience.1-4

The initial proposal of quality indicators suitable for blood establishments and hospital blood banks was published in 2012, after being presented at the ISBT Congress in Cancún.2 The indicators were presented as a list, divided into sections corresponding to the processes within the transfusion chain. This document had several editions, and in 2023 it was completely revised, with the addition of several new quality indicators.5 The quality indicators proposed in this document are categorized in the following groups:

  • Blood donor recruitment, selection, and counseling
  • Blood/blood component collection
  • Blood component preparation
  • Donor/blood component testing
  • Blood component storage/distribution/issue
  • Patient service
  • Quality management

In addition, the new version is supplemented with definitions and information on the importance of each individual quality indicator and the data required for their calculation (numerators and denominators) as shown in the example below.

Table 1. Example: Quality indicator - Aggregates in platelet (PLT) concentrates obtained by apheresis

In 2016, the WP-QM conducted research with the aim of assessing the degree of implementation of quality indicators in blood establishments around the world, the principles of their monitoring and use, and to help them in selecting indicators for quality monitoring. The overall results of this study were published on the ISBT WP-QM website in July 2023.6 The knowledge of quality indicators acquired over the years and the proposal of indicators that could be used by blood establishments and hospital blood banks will enable the comparison of data collected through monitoring at the national and international level. Given that the document on quality indicators is periodically revised, comments and suggestions from interested parties are welcome.

References

  1. Vuk T, Y Qiu, L Bust, P Strengers, C Seidl. Quality monitoring and risk management in blood transfusion services. ISBT Science Series. 2018;13:284-289.
  2. Vuk T. Quality indicators: a tool for quality monitoring and improvement. ISBT Science Series. 2012;7:24-28.
  3. Anyaegbu CC. Quality indicators in transfusion medicine: the building blocks. ISBT Science Series. 2011;6:35-45.
  4. Vuk T. Implementation of ISBT quality indicators in the quality management and haemovigilance systems. ISBT Science Series. 2015;10:371–375.
  5. Vuk T; ISBT Working party on quality management. Quality indicators for blood establishments and hospital blood banks – revision 2023.
  6. Vuk T, Seidl C, Bust L; ISBT Working party on quality management. Survey on quality indicators in blood establishments – Report.
Contents