Auditing as a means of detecting waste

There can be numerous sources of waste in the transfusion service. The most obvious source is wastage of the blood products themselves, either by expiration on the shelf of the blood bank, or else after they have been issued to a patient location in the hospital but not used and not returned to the blood bank in time to be returned into the general inventory. Reducing expiration due to the former mechanism is the sole responsibility of the transfusion service – to make sure that its inventory is commensurate with the volume of transfusions performed at the hospital(s) that it serves. Audits of clinical practice, and the practices in the transfusion service itself, are essential to identify whether these sources of waste are occurring. For example, evaluating the crossmatch:transfusion (C:T) ratio for the various clinical services can identify those that order far more crossmatches compared to the number of red blood cell ( RBC ) units that they transfuse. Addressing and correcting this issue with the services with high C:T ratios can reduce the workload on the transfusion service by when fewer crossmatches are ordered, and the RBC inventory can be more easily managed if fewer RBC s are reserved for specific patients. Auditing the transfusion service can reveal wasteful practices, too. For example, the crossmatch:issue (C:I) ratio can indicate whether the transfusion service is optimizing their process (i.e. method and timing) of performing RBC crossmatches.