Improving Time to Bleeding Disorder Treatment in the Emergency Department

IF 2.4 3区医学 Q2 HEMATOLOGY

Pediatric Blood & Cancer Pub Date : 2025-02-04 DOI:10.1002/pbc.31570

Lisa Littner, Evan Thomas, Laura Mooney, Julie Doyle, Julie Hendrickson, Cristina Tarango

{"title":"Improving Time to Bleeding Disorder Treatment in the Emergency Department","authors":"Lisa Littner, Evan Thomas, Laura Mooney, Julie Doyle, Julie Hendrickson, Cristina Tarango","doi":"10.1002/pbc.31570","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Introduction</h3>\n \n <p>Knowledge of the guidelines for treating people with bleeding disorders (PwBD) is vital for emergency department (ED) staff, as PwBD rely on the ED for treatment of acute bleeding episodes or injuries. Unfamiliarity with these guidelines can delay treatment. We aimed to improve the timely treatment of PwBD seeking emergency care by reducing the mean time-to-factor administration in the ED by 20%, from the baseline of 110 to 88 minutes.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>Our quality improvement (QI) initiative (2019–2024) used Plan-Do-Study-Analyze cycles. Weekly electronic health record (EHR) reports tracked PwBD's time of arrival, admission, clotting factor concentrate ordering, and administration. Interventions targeted delays identified in the process.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Baseline data showed a 110-mean time-time-to-factor. Our aim of reducing the time-to-factor by 20% from the baseline of 110 minutes was reached in May 2020. This improvement was exceeded and sustained throughout the project. At the conclusion, we achieved a 62% reduction in time-to-factor and a mean time-to-factor of 42 minutes.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>By using an EHR tool, we were able to identify when during the ED visit process delays occurred, which helped us better target our interventions. Our educational-based interventions were adapted to reach our intended audiences while working around barriers related to the COVID-19 pandemic, such as high patient volumes and staff shortages. Our results show a decrease in time to factor in the ED and an increase in the PwBD receiving factor within 60 minutes of arrival time. This has been a sustainable improvement.</p>\n </section>\n </div>","PeriodicalId":19822,"journal":{"name":"Pediatric Blood & Cancer","volume":"72 4","pages":""},"PeriodicalIF":2.4000,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pediatric Blood & Cancer","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/pbc.31570","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"HEMATOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Introduction

Knowledge of the guidelines for treating people with bleeding disorders (PwBD) is vital for emergency department (ED) staff, as PwBD rely on the ED for treatment of acute bleeding episodes or injuries. Unfamiliarity with these guidelines can delay treatment. We aimed to improve the timely treatment of PwBD seeking emergency care by reducing the mean time-to-factor administration in the ED by 20%, from the baseline of 110 to 88 minutes.

Methods

Our quality improvement (QI) initiative (2019–2024) used Plan-Do-Study-Analyze cycles. Weekly electronic health record (EHR) reports tracked PwBD's time of arrival, admission, clotting factor concentrate ordering, and administration. Interventions targeted delays identified in the process.

Results

Baseline data showed a 110-mean time-time-to-factor. Our aim of reducing the time-to-factor by 20% from the baseline of 110 minutes was reached in May 2020. This improvement was exceeded and sustained throughout the project. At the conclusion, we achieved a 62% reduction in time-to-factor and a mean time-to-factor of 42 minutes.

Conclusion

By using an EHR tool, we were able to identify when during the ED visit process delays occurred, which helped us better target our interventions. Our educational-based interventions were adapted to reach our intended audiences while working around barriers related to the COVID-19 pandemic, such as high patient volumes and staff shortages. Our results show a decrease in time to factor in the ED and an increase in the PwBD receiving factor within 60 minutes of arrival time. This has been a sustainable improvement.

查看原文本刊更多论文

提高急诊科出血性疾病治疗的时间。

导读：了解出血性疾病（PwBD）患者的治疗指南对急诊科（ED）工作人员至关重要，因为PwBD依赖于急诊科治疗急性出血发作或损伤。不熟悉这些指导方针可能会延误治疗。我们的目标是通过将急诊科的平均给药时间从基线的110分钟减少到88分钟，从而改善寻求急诊治疗的PwBD患者的及时治疗。方法：我们的质量改进（QI）计划（2019-2024）采用计划-执行-研究-分析循环。每周电子健康记录（EHR）报告跟踪PwBD的到达时间、入院时间、凝血因子浓缩物订购和管理情况。干预措施针对的是过程中发现的延误。结果：基线数据显示平均时间-时间-因子为110。我们的目标是在110分钟的基础上减少20%的时间，这一目标已于2020年5月实现。这一改进在整个项目中都得到了超越和维持。最后，我们实现了62%的时间缩短，平均时间为42分钟。结论：通过使用电子病历工具，我们能够确定在急诊科就诊过程中何时发生延误，这有助于我们更好地针对我们的干预措施。我们对基于教育的干预措施进行了调整，以覆盖我们的目标受众，同时克服与COVID-19大流行相关的障碍，例如患者数量多和工作人员短缺。我们的结果表明，在到达时间的60分钟内，ED的时间减少，而PwBD的接收因素增加。这是一个可持续的进步。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Pediatric Blood & Cancer 医学-小儿科

CiteScore

4.90

自引率

9.40%

发文量

546

审稿时长

1.5 months

期刊介绍： Pediatric Blood & Cancer publishes the highest quality manuscripts describing basic and clinical investigations of blood disorders and malignant diseases of childhood including diagnosis, treatment, epidemiology, etiology, biology, and molecular and clinical genetics of these diseases as they affect children, adolescents, and young adults. Pediatric Blood & Cancer will also include studies on such treatment options as hematopoietic stem cell transplantation, immunology, and gene therapy.