A Study of the Utility of Vertical Quality Audits in a Blood Transfusion Centre as a Quality Improvement Tool: Comparison and Differences between Vertical and Horizontal Audits.

Abstract

Introduction: Blood transfusion services is the important part of the modern healthcare system without which efficient medical care is not possible. Blood bank quality audits become an important assessment tool to check the efficiency of the quality system in terms of realization of quality policy, fulfilment of designed targets and implementation of quality system documents. Aim:To study the utility of vertical quality audits as a quality improvement tool, to compare vertical and horizontal audits and explore the differences between them. Methods and materials: The study duration was three years and two months, from November 2018 to December 2021. We conducted an observational prospective study of vertical and horizontal quality audits in a transfusion centre of our tertiary care hospital as per ISO 9001:2000 and National Accreditation Board for Hospitals & Healthcare Providers (NABH) guideline. Results:The most common non-conformities in vertical audit were related to documentation (80%). The donor area was the most common area of blood bank from where non-conformities were observed in vertical audit (60%). The most commonly observed non-conformities in horizontal audit were related to procedural or technical aspects (42.8%). The donor area was the most common area of blood bank from where non-conformities were observed in horizontal audit (57.14%). Conclusions:Quality audits verify compliance and therefore, they are driving continuous quality improvement in a blood bank. Vertical audit is a retrospective process and helps to identify near miss events and errors performed by blood bank staff. Horizontal audits are cumbersome to conduct as compared to vertical audits.