PB0702 - Every Minute Counts: "Door to Factor" Issue Times

Background: Inherited bleeding disorders are rare, and when Persons with Bleeding Disorders (PWBD) access the emergency room (ER), historically healthcare providers do not recognize the urgency of providing timely factor infusions. PWBD do not bleed more at time of injury however, they bleed longer leading to pain, anxiety, hospital admissions, and disabilities.

Aims: To establish a benchmark at Providence Health Care (PHC) for “door to factor issue times” (time between ER registration and factor released from blood bank) in minutes, as a point of reference to compare other Emergency Rooms in B.C. Secondary aim to determine how often the ERs connected with the Adult Bleeding Disorder Program.

Methods: PHC times from ER registration ('door') to factor issue was extracted via Cerner by SPH Transfusion Medicine Lab (TML). Provincial factor infusion data was extracted from the Central Transfusion Registry, Inherited Coagulopathy and Hemoglobinopathy Information Portal, and hospital records.

Results: Established a benchmark time for “door to factor issue time” at PHC, providing a point of reference for other ERs in BC. A baseline was established for how often the program is contacted by ER providers when PWBD present to the ER. The QI initiative provided the Bleeding Disorder Program with data on which hospital ERs experience delays in providing emergency care to PWBD.

Conclusion(s): The establishment of a BC benchmark of "door to factor issue time" over 3 years at the Provincial Bleeding Disorder Program hospital site provides a gauge to measure improvements in timely care of PWBD in the ER. The ongoing QI project includes the establishment of a provincial clinical consultative service for PWBD, improved access to ER care plans and program contact information through the utilization of electronic charting systems, establishing an ER bleeding disorder guideline and BC Patient Safety Learning System (BCPSLS) reporting and review of ER factor treatment delays throughout BC