Quality metrics are critical to the functions of health care delivery. Donor centers, blood banks, and transfusion services have developed quality programs that allow for addressing current and evolving issues in an ever-changing medical landscape. A culture of continual quality improvement in transfusion medicine has been likened to dancing with a gorilla that never tires. However, the commitment to quality has made and continues to make blood products and the processes surrounding their collection, storage, issue, and transfusion better and safer today than ever before.
But therapeutic apheresis is an entirely different gorilla. Various types of procedures, diverse patient populations, fluctuating levels of injury, and non-uniform therapeutic endpoints makes the application of quality concepts to this area more challenging. How can one move their therapeutic apheresis service closer towards performance excellence using the principles of quality to improve processes? In this session, an initial blueprint discussing methods to improve quality and consistency in the therapeutic apheresis service will be presented. Strategies on initial processes such as establishing expectations with consulting providers and providing thorough and consistent documentation will be appraised. Regarding the actual therapeutic apheresis procedures, risk-benefit ratios surrounding routine apheresis parameters, particular treatment intensities, and replacement fluid choices will be highlighted, and the selection and care of vascular access routes will be explored. Lastly, methods for apheresis procedure efficiency monitoring, evidence-based application of routine apheresis calculations, options for assessing therapeutic efficacy, and meaningful assessments of pain surrounding therapeutic apheresis (an organizational requirement as identified by the Joint Commission) will be examined.
Appreciate how definitions and principles of quality apply to therapeutic apheresis.
Identify specific areas in therapeutic apheresis that may benefit from quality assessments.
Evaluate methods to perform quality assessments in therapeutic apheresis and appreciate how these can contribute to a culture of continual improvement.
Division Director of Transfusion Medicine Services,
Houston Methodist Hospital