Transfusion leadership in the hospital.

The hospital environment, across multidisciplinary transfusion processes, is complex involving various organizations and agencies, staff and patients. A comprehensive, robust, collaborative, inclusive and effective clinical governance framework for transfusion/blood management activities is essential for patient safety and optimal outcomes; this should include integrated systems across the transfusion chain which is intrinsically high risk, given the possible severe adverse outcomes of error, multiple potential vulnerabilities and various components not being supported by electronic systems. Strong, informed clinician leadership provides inspiration, motivation and support to staff to achieve excellence in transfusion practice; key leaders should be involved with patient care and facilitate a culture of collaborative teamwork, accountability, openness, engagement and improvement. The transfusion committee (TC) should focus on actions, outcomes, improvement and staff/consumer engagement and be integral to the hospital's overall governance structure; clear accountability to executive is essential so that effective change can be supported, resourced, implemented and maintained. TC membership, activities and reporting lines should be clearly documented. Key clinical personnel, the laboratory, quality and executive all contribute as well as relevant external agencies, for example the blood supplier. The TC leadership team should have expertise in transfusion, leadership qualities and should include a haematologist, transfusion nurse/officer and laboratory scientist. The TC agenda should encompass regular items and reports, policy review, illustrative cases, improvement projects, education, guidelines/research and information sharing/benchmarking with other groups. Small TC working groups facilitate progress between meetings. Enablers and barriers to good transfusion practice include system issues, evidence barriers and individual factors. [ABSTRACT FROM AUTHOR]