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The use of lower thresholds for transfusing red blood cells (RBC) has effectively reduced the number of RBC transfusions performed. When healthcare providers order a blood transfusion, they request the number of RBC units that should be transfused. Most orders are for either 1 (single) unit or 2 (double) units of RBC in non-emergent scenarios. This includes inpatient transfusions provided to acute and chronically ill patients, post-operative patients, and patients in intensive care unit settings. However, the need to transfuse 2 RBC units during a transfusion episode has been questioned because a single unit transfusion may sufficiently increase oxygen carrying capacity for most patients.

Enrollment in this study will assist laboratories in meeting the CAP Laboratory Accreditation Program Transfusion Checklist statement TRM.40875, Transfusion Service Medical Director Responsibility, regarding monitoring and auditing transfusion practices, and establishing criteria for transfusion. Use of this study assists laboratories in meeting and applying The Joint Commission Standards QSA.05.01.01 and 05.02.01 requirements for policies and procedures for blood transfusion services.


This Q-PROBES study will allow participants to assess how frequently single RBC units are ordered and subsequently transfused to hospitalized patients requiring non-emergent transfusions compared to all transfusion events with either single or double RBC units ordered. Additionally, this study will allow participants to evaluate conformance of RBC transfusion practice with their own institutional guidelines.

Data Collection

Participants will identify up to 50 transfusion events from patients treated and recieved either 1 or 2 RBC unit(s). This study will be limited to hospital inpatients. Preoperative and intraoperative orders for surgical patients and emergency orders for RBC transfusion will be excluded. Orders for 3 or more RBC units will be excluded as these are often unstable patients requiring urgent transfusion.

For each of the eligible transfusion episodes, participants will record the pre-transfusion and post-transfusion hemoglobin levels and the type of ordering service.

Performance Indicators

  • Percentage of single RBC transfusion events out of all transfusion events administering single or double RBC units during the study period
  • Percentage of RBC transfusions in compliance with institutional guidelines during the study period

Shipping Schedule

B Mailing: March 16, 2020

Additional Measure

  • Average pre-RBC transfusion hemoglobin value

Additional Information

This is a one-time study conducted in the second quarter.

Q-PROBES qualify for Self-Reported Training Opportunities to be used for fulfilling requirements for certification maintenance by agencies such as the American Society for Clinical Pathology (ASCP). Please verify with your certifying agency to determine your education requirements.

For Comprehensive Collection of Tools, see Quality Management Tools.

Select Q-PROBES and Q-TRACKS studies to support your quality improvement initiatives.
Anatomic Pathology
Clinical Pathology
Turnaround Time
Patient Safety
Transfusion Medicine
Chemistry/ Hematology
Customer Satisfaction
Technical Competency Assessment of Peripheral Blood Smears (QP201)
Red Blood Cell Utilization: Single and Double Unit Transfusions (QP202)
Inpatient Test Utilization and Volume Benchmarking (QP203)
Turnaround Time for Image with Guided Breast Needle Biopsy Specimens (QP204)
Patient Identification Accuracy (QT1)
Blood Culture Contamination (QT2)
Laboratory Specimen Acceptability (QT3)
In-Date Blood Product Wastage (QT4)
Gynecologic Cytology Outcomes: Biopsy Correlation Performance (QT5)
Satisfaction with Outpatient Specimen Collection (QT7)
Stat Test Turnaround Time Outliers (QT8)
Critical Values Reporting (QT10)
Troponin Turnaround Times (QT15)
Corrected Results (QT16)
Outpatient Order Entry Errors (QT17)

*The CAP requires accredited laboratories to have a quality management plan that covers all areas of the laboratory and includes benchmarking key measures of laboratory performance (GEN.13806, GEN.20316, COM.04000). The Joint Commission requires accredited hospitals to regularly collect and analyze performance data (PI.01.01.01, PI.02.01.01). CLIA requires laboratories to monitor, assess, and correct problems identified in preanalytic, analytic, and postanalytic systems (§493.1249, §493.1289, §493.1299).