Implementation of CPOE, ERBI, and ePPID in Critical Care Operating Rooms at a Tertiary Care Academic Center

Abstract

Abstract Introduction/Objective Blood transfusion in operating rooms (ORs) is a critical and complex process, often complicated by issues such as paper-based orders, lack of guidelines, and delays in blood delivery. In response, a multidisciplinary task force developed a quality improvement plan. This study assesses the impact of implementing an electronic positive patient identification (ePPID) system, standardized computer provider order entry (CPOE), and electronic remote blood issue (ERBI) process in a critical care OR setting at our institution. Methods/Case Report The team initially implemented ePPID in cardiac surgery ORs before expanding hospital-wide. CPOE was developed in collaboration with the laboratory information systems (LIS) and hospital information technology (IT). ERBI required cross-departmental coordination to establish a bi-directional interface between LIS and ERBI software. Staff received training through a train-the-trainer approach, interactive sessions, videos, and surveys. CPOE focused on order set development and creating the Maximum Surgical Blood Order Schedule (MSBOS). ePPID began with a pilot program and expanded with training sessions. Data collection tracked blood ordering, ERBI workflow, and transfusion data for compliance and utilization rates. Results (if a Case Study enter NA) The implementation of ePPID saw a rise in compliance rates from 71% to 98%, with 60 completed cases and 233 blood products transfused by 24 clinicians. ePPID’s utilization for blood products increased from 60% to 98% within 90 days. ERBI lowered RBC return rates from 30% to 15% and plasma return rates from 45% to 35% over a 2.5 year span. ERBI utilization rates reached 81% at 24 months post-implementation. Conclusion The implementation of ePPID, CPOE, and ERBI in critical care ORs was well-received among clinicians. Significant improvements in compliance and utilization rates for blood products following ePPID implementation were evident. ERBI implementation also led to substantial reductions in return rates of blood products allocated to ORs. The steady increase in ERBI utilization indicates successful integration into OR workflows.