Advancing Blood Transfusion Safety through Closed-Loop Management and Intelligent Transfusion Processes - Experience Sharing from a Medical Center in Northern Taiwan.

Blood transfusion therapy is a critical medical intervention that relies heavily on manual identification due to its complex steps and the involvement of numerous personnel. Any error in this process can have severe consequences, potentially leading to patient mortality, making it inherently high-risk. Both JCAHO and SHOT recognize blood transfusion errors as sentinel events. In the annual medical quality and patient safety goals for 2022~2023 in Taiwan, there is a requirement for the implementation of safety inspections for surgical transfusions and blood preparation.

We are integrating the Hospital Information System and blood bank management with the Laboratory Information System, Nursing Information System, and other systems. The blood transfusion process is being improved through the incorporation of automated equipment, computer information interfaces, and mobile app programs. Concurrently, a closed-loop management system for the blood transfusion process is being implemented to enhance safety and optimize the process.

We are integrating the Hospital Information System and blood bank management with the Laboratory Information System, Nursing Information System, and other systems. The blood transfusion process is being improved through the incorporation of automated equipment, computer information interfaces, and mobile app programs. Concurrently, a closed-loop management system for the blood transfusion process is being implemented to enhance safety and optimize the process.

After the introduction of computerization, the incomplete rate of medical orders from January 2022 to August 2024 dropped to 0%, and the inconsistency between test orders and specimens during the same period also decreased to 0%. Meanwhile, the reporting rate of the blood transfusion monitoring system exceeded 99%.

Through computerized specimen collection, testing, blood storage, and transportation, as well as an intelligent closed-loop blood transfusion management system, not only can the blood transfusion process be monitored in real-time, but manual verification and recording can also be significantly reduced. Additionally, active warning and error-proofing functions have been integrated into the computer system. This not only directly minimizes human errors but enhances blood transfusion safety. Moreover, it contributes to the reduction of paper and ink cartridge usage, aligning with the goals of energy conservation, carbon reduction, and the pursuit of a sustainable world.