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ASH Quality Improvement Champions are standardizing treatment, implementing clinical guidelines to improve patient safety

(WASHINGTON, August 27, 2024) – The 91¹ú²ú¾«Æ· (ASH) recognizes Josie Fernandez Sanchez, MD, of Texas Children’s Hospital, Baylor College of Medicine; Paolo Lopedote, MD, of St. Elizabeth’s Medical Center, Boston University; and Asinamai M. Ndai, BPharm, MS, of University of Florida Health Physicians, as its inaugural Quality Improvement Champions.

ASH’s Quality Improvement Champions initiative combines and replaces the retired Choosing Wisely Champions and Guideline Implementation Champions initiatives, recognizing 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 projects address harmful overuse or underuse of tests and procedures, and the successful implementation of clinical guideline recommendations to enhance patient safety and positively impact health care delivery. The champions’ work ranges from standardizing anemia care and delays in hemophilia treatment in the emergency department to reducing unnecessary transfusions for patients with chronic liver disease.

The 2024 ASH Quality Improvement Champions will speak during a Special Interest Session at the 66th ASH Annual Meeting and Exposition in San Diego, California, taking place December 7 – 10, 2024. During this session, the Society will recognize the champions’ efforts and offer attendees the opportunity to ask questions and learn about strategies for implementing similar projects at their own practices.

The 2024 ASH Quality Improvement Champions:

Josie Fernandez Sanchez, MD (Texas Children’s Hospital, Baylor College of Medicine)
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 (St. Elizabeth’s Medical Center, Boston University)
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 (University of Florida Health Physicians)
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.

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The 91¹ú²ú¾«Æ· (ASH) (hematology.org) is the world’s largest professional society of hematologists dedicated to furthering the understanding, diagnosis, treatment, and prevention of disorders affecting the blood. Since 1958, the Society has led the development of hematology as a discipline by promoting research, patient care, education, training, and advocacy in hematology.   

The Blood journals () are the premier source for basic, translational, and clinical hematological research. The Blood journals publish more peer-reviewed hematology research than any other academic journals worldwide. 

Claire Whetzel, 202-629-5085
[email protected]