In many countries it is mandated to have HTCs in place. HTCs have been created in different countries to oversee transfusion activity within their scope. Whereas the approaches used to achieve their goals have varied historically and between nations, their principles are the same (1). A functional HTC, fulfilling its mandate, can be a powerful mechanism to ensure patients receive the safest and most appropriate blood transfusion therapy possible (4). The WHO (2001) recommendations on developing a national policy and guidelines on the clinical use of blood indicate that an HTC ‘should be set up in each hospital to implement the national policy and guidelines on the clinical use of blood and monitor the use of blood and blood products at the local level.’ It goes on to say that the HTC ‘should have authority within the hospital structure to determine hospital policy in relation to transfusion and resolve any problems that have been identified.’
HTCs can be pivotal in ensuring appropriate blood utilization and that best practice standards are followed. Where the primary goal for HTCs are to improve patient safety there is a number of roles they may have (1,2,3,4).
1) Developing systems for the implementation of national guidelines within the hospital – defining blood transfusion policies
2) Monitor the implementation of national guidelines in the hospital and take appropriate action to overcome any factors that may be hindering their effective implementation
3) Liaison with blood transfusion services to ensure availability of required blood and blood components and be aware of the importance of horizon scanning
4) Training and assessment for all staff in the hospital that are involved in the blood transfusion process
5) Monitoring the usage of blood and blood components within the hospital and contribute to benchmarking against others
6) Reducing blood component loss due to time expiry and other wastage reasons – linking into clinical areas where clinical wastage is deemed high
7) Monitoring, reporting and investigating transfusion adverse events and near misses and using these experiences to promote learning
8) Ensure a cycle of clinical audits to check transfusion practice and safety and compliance to national requirements
9) Reduce the number of incidents in which an inappropriate dose of component is given to a patient
10) Disseminating transfusion related information to users including changes to national guidance, audit results and examples of good practice
11) Implementing PBM initiatives – reviewing transfusion alternatives and making recommendations of their use
12) Transfusion governance – be the link with regulatory authorities and agree any submissions and inspection outcomes
13) Reviewing if recall and other quality manual processes work as intended
Some HTC functions and requirements are written into local country legislation and law and compliance attracts a financial premium.