Document Detail

Effectiveness of a prospective physician self-audit transfusion-monitoring system.
MedLine Citation:
PMID:  9191817     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The purpose of this study was to search for a more effective transfusion-monitoring system than the existing system of retrospective peer review. STUDY DESIGN AND METHODS: This research used a study-control, preintervention and postintervention design, to evaluate the effectiveness of a prospective physician self-audit transfusion-monitoring system that functioned without the direct involvement of transfusion service physicians. This research also evaluated the effectiveness of issuing to physicians a memo with transfusion guidelines. Three process indicators were used to assess physician behavior at various stages of the blood-ordering process: 1) the number of crossmatches ordered per admission, 2) the transfusion-to-crossmatch ratio, and 3) the number of blood units returned to the laboratory after physician self-auditing. The study used two outcome indicators to reflect overall blood utilization: 1) the percentage of patients who received red cell transfusions and 2) the number of blood units transfused per recipient each month. RESULTS: The prospective physician self-audit system implemented at the study hospital did not reverse physician transfusion decisions, and the process of issuing to physicians a memo with transfusion guidelines at the control hospital failed to reduce blood usage. However, a transient reduction in blood utilization was observed at the study hospital. CONCLUSION: The reduction was hypothesized to be due to a Hawthorne effect, in which observed behavior is affected by the subject's awareness of the research study.
H T Lam; S O Schweitzer; L Petz; M H Kanter; D A Bernstein; S Brauer; D V Pascual; B A Myhre; I A Shulman; G W Sun
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Transfusion     Volume:  37     ISSN:  0041-1132     ISO Abbreviation:  Transfusion     Publication Date:  1997 Jun 
Date Detail:
Created Date:  1997-07-01     Completed Date:  1997-07-01     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0417360     Medline TA:  Transfusion     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  577-84     Citation Subset:  IM    
School of Public Health, University of California, Los Angeles, USA.
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MeSH Terms
Blood Grouping and Crossmatching
Blood Transfusion / standards*
Peer Review* / standards
Prospective Studies
Retrospective Studies

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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