Quality Improvement Champions
The Quality Improvement Champions Initiative combines and replaces the retired Choosing Wisely Champions and Guideline Implementation Champions. ASH recognizes the efforts of practitioners who have implemented intervention-based projects focused on improving the quality of care delivered in their practice, institution, or hospital system. These may include projects that work to address harmful overuse and/or underuse of tests and procedures, to better implement clinical guideline recommendations, to enhance patient safety, or any other project that has demonstrated a positive impact on healthcare delivery. Projects are from clinicians, trainees, nurse practitioners and allied health professionals at all career levels, in both academic and community settings. This includes the full spectrum of hematology, including adult and pediatric, malignant and classical hematology, and transfusion medicine.
2024 ASH Quality Improvement Champions
Josie Fernandez Sanchez, MD
Institution: Texas Children’s Hospital, Baylor College of Medicine
Project Title: Standardizing Emergency Department Management of Anemia from Heavy Menstrual Bleeding
Comprehensive guidelines for managing iron deficiency anemia in adolescent patients who come to the emergency department with heavy menstrual bleeding are lacking, which leads to substantial variability in hematology consultation, laboratory evaluation, and therapy administration. Dr. Fernandez Sanchez and her colleagues collaborated with pediatric hematologists, gynecologists, emergency medicine physicians, and hospitalists to create and implement an evidence-based algorithm for evaluating these patients and managing their symptoms.
Implementation of the algorithm led to 100% adherence to the recommended therapy choice and involvement of pediatric hematologists before appropriately discharging the patient from the emergency department. Dr. Fernandez Sanchez and her colleagues also identified barriers to implementing the algorithm and developed strategies to improve adherence.
Paolo Lopedote, MD
Institution: City of Hope
Project Title: Reduced Blood Transfusions in Patients with Chronic Liver Disease Undergoing Paracentesis
For patients with chronic liver disease, guidelines recommend against transfusing fresh frozen plasma or platelets before procedures with a low risk of bleeding, including paracentesis, a procedure that removes excess fluid from the abdomen.
Dr. Lopedote and his colleagues realized that up to 73% of patients at his institution with chronic liver disease and abnormal platelet counts or blood clotting received unnecessary plasma or platelet transfusions before paracentesis, which can lead to delays in care, increased risk, and costs. Drawing on evidence-based recommendations, he and his colleagues created a hospital task force and educational flyers to dispel misconceptions and address knowledge gaps about this issue. Between February 2023 and December 2023, the rate of plasma or platelet transfusion before paracenteses in this patient population decreased by 75%
Asinamai M. Ndai, BPharm, MS
Institution: University of Florida Health Physicians
Project Title: Optimized Management of Hemophilia in the Emergency Department
The National Bleeding Disorders Foundation recommends that patients with hemophilia who come to the emergency department with bleeding receive factor replacement therapy within one hour of arrival. Factor replacement therapy helps induce clotting to prevent and treat bleeding episodes. However, such patients who arrived at the University of Florida Health emergency rooms experienced a delay in receiving this treatment.
Mr. Ndai and his colleagues started a continuous quality improvement initiative to reduce the delay in administering factor replacement therapy to patients with hemophilia who come to the emergency department. The initiative trained physicians in the emergency department on hemophilia guidelines, created a specialized medication order set in the electronic health record system, and implemented a rapid triage system. After the intervention, the average time a patient with hemophilia in the emergency department received factor replacement therapy decreased from 5.63 hours to 3.15 hours.
Choosing Wisely and Guideline Implementation Champions Project Archive
Explore Choosing Wisely and Guidelines Implementation Champions to learn about successful approaches that may be implemented in your own institution.