Appropriateness Update

A more complete update will be provided in the next issue as Department Head members present their progress reports at their virtual wall walk at the meeting on September 27^th. In the interim progress has been made in the following areas:

• Audit of Transfusions
• Audit of Charts in Medicine including H&P; Progress Notes; Plan of Care; Use of the Medicine PPO
• Audits of chart completion are also continuing with significant progress across many areas.
• Audit on the use of the new MRI Back Pain Protocol demonstrates 100% compliance by RQHR physicians.
• A development plan for reform of the pre-operative assessment program initiated by the Department of Anesthesia has now engaged the Sections of Internal Medicine and Orthopedics.
• Very significant improvements have been made in Lab Use within the Departments of Critical Care and in the Accountable Care Unit.
• The Accountable Care Unit has also made significant improvements in Pneumococcal Vaccine use and in Anti-microbial Stewardship.

Transfusion Safety Update

August 16, 2016

Transfusion Safety Department update on Procedural Consent forms (RQHR 370 – inpatients and RQHR 254 – outpatients):

In September 2014, integrated procedural consent forms were rolled out, incorporating consent/refusal for both transfusion and blood-borne infection testing. This has raised RQHR’s rate of documented informed consent for transfusion from 0% in 2012-13 to 84% in 2016. We are proud of this significant improvement and thank all who have worked so diligently to bring it about.

There continue to be challenges when the risk of transfusion is so low that a consent discussion is - in the opinion of the responsible physician - not required. The original wording was “not applicable”. Recent consultations with nursing, Surgical Executive and the RQHR Transfusion Committee have led to a decision to present this choice in more direct language. The “Not applicable” box will now read “Transfusion not routinely required”.

The Transfusion Safety Department is pleased to announce the updated versions (May 2016) of the RQHR 370 and 254 forms are available in the EMR databases and through the RQHR Print Shop. Please update all surgical bundles and office EMRs to ensure the most current versions are being used.

Thank you for your partnership in Transfusion Safety.