{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T22:25:13Z","timestamp":1785450313135,"version":"3.56.0"},"reference-count":15,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,2,4]],"date-time":"2025-02-04T00:00:00Z","timestamp":1738627200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Knowledge of the guidelines for treating people with bleeding disorders (PwBD) is vital for emergency department (ED) staff, as PwBD rely on the ED for treatment of acute bleeding episodes or injuries. Unfamiliarity with these guidelines can delay treatment. We aimed to improve the timely treatment of PwBD seeking emergency care by reducing the mean time\u2010to\u2010factor administration in the ED by 20%, from the baseline of 110 to 88\u00a0minutes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Our quality improvement (QI) initiative (2019\u20132024) used Plan\u2010Do\u2010Study\u2010Analyze cycles. Weekly electronic health record (EHR) reports tracked PwBD's time of arrival, admission, clotting factor concentrate ordering, and administration. Interventions targeted delays identified in the process.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Baseline data showed a 110\u2010mean time\u2010time\u2010to\u2010factor. Our aim of reducing the time\u2010to\u2010factor by 20% from the baseline of 110\u00a0minutes was reached in May 2020. This improvement was exceeded and sustained throughout the project. At the conclusion, we achieved a 62% reduction in time\u2010to\u2010factor and a mean time\u2010to\u2010factor of 42\u00a0minutes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>By using an EHR tool, we were able to identify when during the ED visit process delays occurred, which helped us better target our interventions. Our educational\u2010based interventions were adapted to reach our intended audiences while working around barriers related to the COVID\u201019 pandemic, such as high patient volumes and staff shortages. Our results show a decrease in time to factor in the ED and an increase in the PwBD receiving factor within 60\u00a0minutes of arrival time. This has been a sustainable improvement.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.31570","type":"journal-article","created":{"date-parts":[[2025,2,5]],"date-time":"2025-02-05T04:49:31Z","timestamp":1738730971000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Improving Time to Bleeding Disorder Treatment in the Emergency Department"],"prefix":"10.1002","volume":"72","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0340-0045","authenticated-orcid":false,"given":"Lisa","family":"Littner","sequence":"first","affiliation":[{"name":"Division of Hematology Cancer and Blood Disease Institute Cincinnati Children's Hospital Medical Center  Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evan","family":"Thomas","sequence":"additional","affiliation":[{"name":"Division of Hematology Cancer and Blood Disease Institute Cincinnati Children's Hospital Medical Center  Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Mooney","sequence":"additional","affiliation":[{"name":"Division of Hematology Cancer and Blood Disease Institute Cincinnati Children's Hospital Medical Center  Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Doyle","sequence":"additional","affiliation":[{"name":"Division of Hematology Cancer and Blood Disease Institute Cincinnati Children's Hospital Medical Center  Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Hendrickson","sequence":"additional","affiliation":[{"name":"Division of Hematology Cancer and Blood Disease Institute Cincinnati Children's Hospital Medical Center  Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0283-9972","authenticated-orcid":false,"given":"Cristina","family":"Tarango","sequence":"additional","affiliation":[{"name":"Division of Hematology Cancer and Blood Disease Institute Cincinnati Children's Hospital Medical Center  Cincinnati Ohio USA"},{"name":"University of Cincinnati College of Medicine  Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,2,4]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/hae.13187"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/hae.14046"},{"issue":"9","key":"e_1_2_11_4_1","first-page":"1","article-title":"Hemophilia and Von Willebrand Disease in Children: Emergency Department Evaluation and Management","volume":"12","author":"Schwartz K. R.","year":"2015","journal-title":"Pediatric Emergency Medicine Practice"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jemermed.2007.12.024"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365\u20102516.2011.02721.x"},{"key":"e_1_2_11_7_1","unstructured":"MASAC \u201cMedical and Scientific Advisory Council (MASAC)Document 257 \u2010 Guidelines for Emergency Department Management of Individuals With Hemophilia and Other Bleeding Disorders \u201dNational Bleeding Disorders Foundation accessed June 5 2024 https:\/\/www.hemophilia.org\/healthcare\u2010professionals\/guidelines\u2010on\u2010care\/masac\u2010documents\/masac\u2010document\u2010257\u2010guidelines\u2010for\u2010emergency\u2010department\u2010management\u2010of\u2010individuals\u2010with\u2010hemophilia\u2010and\u2010other\u2010bleeding\u2010disorders."},{"key":"e_1_2_11_8_1","unstructured":"W. K.Hoots Emergency Care Issues in Hemophilia Treatment of Hemophilia Montreal: World Federation of Hemophilia (WFH)(World Federation of Hemophilia 2007)."},{"key":"e_1_2_11_9_1","unstructured":"MASAC \u201cMedical and Scientific Advisory Council (MASAC) Document 242 \u2010 Recommendations Regarding Doses of Clotting Factor Concentrate in the Home \u201dNational Bleeding Disorders Foundation accessed June 5 2024 https:\/\/www.hemophilia.org\/healthcare\u2010professionals\/guidelines\u2010on\u2010care\/masac\u2010documents\/masac\u2010document\u2010242\u2010recommendations\u2010regarding\u2010doses\u2010of\u2010clotting\u2010factor\u2010concentrate\u2010in\u2010the\u2010home."},{"key":"e_1_2_11_10_1","unstructured":"\u201cHow to Improve: Model for Improvement \u201dInstitute for Healthcare Improvement accessed November 29 2024."},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.3109\/0142159X.2012.650741"},{"issue":"1","key":"e_1_2_11_12_1","first-page":"15","article-title":"Health Marketing and Behavioral Change: A Review of the Literature","volume":"11","author":"Chichirez C.\u2010M.","year":"2018","journal-title":"Journal of Medicine and Life"},{"key":"e_1_2_11_13_1","unstructured":"B.Sobolewski \u201cFactor First! Hemophilia Management in the Emergency Department \u201dPEM Blog 2024 https:\/\/pemcincinnati.com\/blog\/factor\u2010first\u2010hemophilia\u2010management\u2010in\u2010the\u2010emergency\u2010department\/."},{"key":"e_1_2_11_14_1","unstructured":"B.Sobolewski \u201cProphylactic Treatments for Hemophilia: A Prophylactic Treatment for Hemophilia that You Should Know \u201dPEM Blog 2023 https:\/\/pemcincinnati.com\/blog\/a\u2010prophylactic\u2010treatment\u2010for\u2010hemophilia\u2010that\u2010you\u2010should\u2010know\u2010about\/."},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2516.2010.02450.x"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2516.2008.01876.x"}],"container-title":["Pediatric Blood &amp; Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pbc.31570","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,12]],"date-time":"2025-03-12T06:19:46Z","timestamp":1741760386000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/pbc.31570"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,4]]},"references-count":15,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025,4]]}},"alternative-id":["10.1002\/pbc.31570"],"URL":"https:\/\/doi.org\/10.1002\/pbc.31570","archive":["Portico"],"relation":{},"ISSN":["1545-5009","1545-5017"],"issn-type":[{"value":"1545-5009","type":"print"},{"value":"1545-5017","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,4]]},"assertion":[{"value":"2024-08-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-01-20","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-02-04","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e31570"}}