Two-Year Audit of Blood Transfusion Quality Indicators at a Tertiary Hospital in Beirut: Benchmarking and Impact of Quality Improvement Interventions

Document Type

Conference Proceeding

Publication Date

6-18-2026

Publication Title

Vox Sang

Keywords

adult, benchmarking, blood sampling, blood transfusion, blood transfusion reaction, clinical audit, combinatorial library, conference abstract, donor selection, hemolysis, human, Lebanon, major clinical study, male, nursing staff, patient safety, protocol compliance, retrospective study, serology, tertiary care center, thrombocytopheresis, thrombocytosis, total quality management, World Health Organization

Abstract

Background: Continuous monitoring of blood transfusion quality indicators is essential to ensure patient safety and efficient resource utilization. Benchmarking against international standards supports targeted improvements, particularly in resource-constrainedsettings. Regional data reporting longitudinal outcomes across the transfusion chain remain limited. Aims: To evaluate blood transfusion quality indicators over two years at Makassed General Hospital (MGH), Beirut, Lebanon, compare 2025 performance against institutional thresholds 2024 and international benchmarks, and assess the impact of implemented quality improvement measures. Methods: A retrospective audit of standardized quality indicators from QS-F 11 reports at MGH, a 200-bed tertiary hospital was conducted for 2024 and 2025.Performance was compared with internal thresholds and WHO/AABB/FDA/CAP/NABH benchmarks. Seven domains were assessed: donor recruitment/selection, collection, component preparation, testing, storage/distribution, patient service, and quality management. Interventions included stricter policy adherence, redistribution of short-dated units to high-utilization departments, acceptance of outside blood (<7 days old) and platelets (≤2 days old), and structured nursing staff training (completed January 2026). Results: The total donor deferral rate declined from 19.1% (2024) to 15.3% (2025). Temporary deferrals decreased from 12.4% to 10.5%, and permanent deferrals from 2% to 1.3%. Donor deferral rate due to low Hb fell from 2.78% to 1.7%. Positive serology deferrals decreased from 2.46% to 2%. Whole-blood collection failures improved from 0.43% to 0.2%, and platelet apheresis failures from 0.15% to 0.03%. Donor adverse reactions declined from 0.24% to 0.17%. Nonconforming components decreased from 0.15% to 0.035%, with hemolysis eliminated (0%). Testing quality remained optimal with zero IQC or proficiency failures. Expired RBC units were 0% both years; expired platelets increased from 0.3% to 0.42% (benchmark<2%). Wrong component issue was 0% throughout. Crossmatchto-transfusion ratio remained efficient 1.3 (2024) and 1.4(2025) (benchmark<2). Emergency un-crossmatched RBC declined from 1.12% to 0.45%. Transfusion reactions were low (<1%). Returned components fell from 22.4% to 19.1%. However incomplete post-transfusion documentation >15% remained above target (benchmark<10%) Summary/Conclusions: MGH demonstrated strong patient safety outcomes and effective laboratory quality management. Targeted interventions were associated with measurable improvements in donor screening, collection quality, component conformity, and emergency transfusion practices. Persistent challenges in inventory utilization and documentation highlight areas for further optimization.

Volume

121

First Page

189

Last Page

190

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