Intervention webpage: https://usingbloodwisely.ca/intervention/

Please feel free to enter your questions into the chat box.

Would you explain the repeat audit. We submitted the spot audit and I wasn't aware that a repeat audit was required. Also if we are submitting every second month, when does this start. Will it start in a calendar year Jan-Dec 2021?

If we haven't been able to co-ordinate any interventions yet to improve statistics, should we wait until we can to do subsequent audits?

How do we account for transfusions with no Hb result in 24 hours?

Our hospitals have 50+ transfusion per month. We have submitted audit data for August as our baseline. Since then we have data for Sept, October and December. If one month is below the target, do we still need to continue to audit until we have 4 months worth of data that are meeting the targets?

When my data is pulled, all of my transfusion episodes in a single day are combined (eg 1 unit in AM, 1 unit in PM show as 2 units for the day) so I can't tell when the actual transfusions occurred. For those patients with multiple Hb results in 24 hours, which one should I be using for the sudit?

sorry, audit

We did Sept - Dec. We have 75 units and met all benchmarks. Can we submit for Accreditation?

My hospital is the Level 1 trauma center and Cardiac Surgery Center for the province. I noticed through the audit that many of the 2 RBC transfusions were given in SICU, where trauma & OR patients go after surgery. These patients are not stable, but must be included in my single RBC transfusions. After 2 audits my hospital has maintained 61% for single volume transfusions due to these patient demographics.

Designation application: https://usingbloodwisely.ca/designation/

Hi this is Millie Hamlyn. We submitted Sept 2020, does that mean we now submit Nov 2020 and Jan, and March of 2021.

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yes

It was 75 per month

YAY Thank you

We were in the START study

I also noticed that the hgb were below 70 in many cases.

That would be very helpful. we also are the oncology center for the provinces

Hi This is Archana,

Curious as to how viscoelastic testing impacts choosing blood wisely initiative?

Bimonthly still means that I conduct the audit for each month and submit bothmonths data at once?

thank you

Please let us know how the pandemic is/may effect your efforts and any challenges you forsee

Biggest challenge - conveining our Transfusion Committee - getting quorum - to be able to start work to impliment some of the initiatives.

Our patients have not changed or slowed down at all so we haven't had any issues with gathering data.

Less OR's, but most of our OR's didn't use units anyway.

There has been some concern with staff's capacity (time available) to do the audits. In many sites the lab staff are doing this manually and of course there has been a huge demand on their time with the pandemic. Our plan is to work toward automating the process in most locations

Please feel free to unmute yourselves to share your comments!

It was easier to have screening conversations with physicians when there was a shortage/threatened shortage.

To Donna, If you get your MAC on board to change the requirements, it becomes easier to be the bad guy.

Yes, we will look forward to the provincial and national benchmarks.

Yes, we're trying to get local champions.

We implemented in a heck of a hurry in March

Knowledge is power!

Out of curiosity, are any sites also bring nursing into the conversation? Sometimes the nurses on the floor can influence physician ordering

In the START study we relied heavily on the nurses, which sometimes put them in the middle. But they did a great job.

Nurses on our PBM committee were very helpful

It's really a wonderful thing

agreed

Thanks for the great conversations and bringing us together today. It is nice to see so many familiar names working together!

Thank you from rural NB.

Thanks great perspective!

Thanks everyone.

Website: www.UsingBloodWisely.ca

For questions, please email:blood@choosingwiselycanada.org

We have also shared the UBW QI project with our nurses using their Clinical Practice and Education meeting. It is a wonderful way to communicate with the nurses. And thank you for this opportunity to make things better for our patients.

it's wonderful to have CWC's support! it certainly helps having a national voice for effective implementation!