{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T12:31:39Z","timestamp":1789129899649,"version":"build-2803163510"},"reference-count":30,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T00:00:00Z","timestamp":1789084800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T00:00:00Z","timestamp":1789084800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health and Care Research","doi-asserted-by":"publisher","award":["NIHR203334"],"award-info":[{"award-number":["NIHR203334"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transfusion Medicine"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Patient blood management (PBM) including\n                      <jats:italic>appropriate<\/jats:italic>\n                      red blood cell (RBC) transfusion underpins the management of severe anaemia and haemorrhage during pregnancy, delivery and postpartum. However, there is marked variation in practice despite guidelines and standards. Key performance indicators (KPIs) can identify deviation from agreed standards, support benchmarking and guide efforts to improve outcomes. We aimed to develop a set of obstetric PBM KPIs which may be measured from routinely collected electronic health records.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We undertook a three\u2010stage process. First, we completed a scoping review to identify potential KPIs from relevant literature and clinical guidelines. Second, we conducted a modified RAND consensus process with a multidisciplinary panel of medical professionals. The consensus panel rated potential KPIs according to importance and feasibility. Third, our research team undertook a \u2018sense check\u2019 to refine and make the final selection of the KPIs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Out of 25 candidate KPIs initially identified, we derived a final set of 10 KPIs covering PBM in obstetrics and the RBC transfusion practice. Fifteen candidate KPIs were rejected: 6 KPIs were judged neither important nor feasible, 2 not feasible for further study at the current time, 2 not important to the general obstetric population and 5 represented organisation of care, rather than clinical practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Using a systematic, stepwise, transparent approach, we have developed a set of 10 KPIs based on routine health data sources to monitor and guide improvement of PBM implementation, particularly RBC transfusion practice in obstetrics. These KPIs now require further field testing using routinely collected data.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/tme.70115","type":"journal-article","created":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T11:46:37Z","timestamp":1789127197000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Developing key performance indicators using routinely collected healthcare data in obstetric patient blood management: A multi\u2010stage consensus study"],"prefix":"10.1111","author":[{"given":"Kate","family":"Fletcher","sequence":"first","affiliation":[{"name":"Haematology Department Guy's and St Thomas' NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hayley","family":"Evans","sequence":"additional","affiliation":[{"name":"NIHR Blood and Transplant Research Unit in Data Driven Transfusion Practice, Nuffield Division of Clinical Laboratory Sciences, Radcliffe Department of Medicine The University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asma","family":"Tameez\u2010Uddin","sequence":"additional","affiliation":[{"name":"Haematology Department Guy's and St Thomas' NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gurman","family":"Kaur","sequence":"additional","affiliation":[{"name":"NHS Blood and Transplant John Radcliffe Hospital  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akshay","family":"Shah","sequence":"additional","affiliation":[{"name":"NIHR Blood and Transplant Research Unit in Data Driven Transfusion Practice, Nuffield Division of Clinical Laboratory Sciences, Radcliffe Department of Medicine The University of Oxford  Oxford UK"},{"name":"Department of Anaesthesia Hammersmith Hospital, Imperial College Healthcare NHS Trust  London 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UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7414-4950","authenticated-orcid":false,"given":"Simon J.","family":"Stanworth","sequence":"additional","affiliation":[{"name":"NIHR Blood and Transplant Research Unit in Data Driven Transfusion Practice, Nuffield Division of Clinical Laboratory Sciences, Radcliffe Department of Medicine The University of Oxford  Oxford UK"},{"name":"NHS Blood and Transplant John Radcliffe Hospital  Oxford UK"},{"name":"Department of Haematology Oxford University Hospitals NHS Foundation Trust  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5279-5536","authenticated-orcid":false,"given":"Susan","family":"Robinson","sequence":"additional","affiliation":[{"name":"Haematology Department Guy's and St Thomas' NHS Foundation Trust  London UK"},{"name":"NIHR Blood and Transplant Research Unit in Data Driven Transfusion Practice, Nuffield Division of Clinical Laboratory Sciences, Radcliffe Department of Medicine The University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"For the NIHR Blood and Transplant Research Unit in Data Driven Transfusion Practice","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,11]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"crossref","first-page":"e627","DOI":"10.1016\/S2214-109X(22)00084-5","article-title":"National, regional, and global estimates of anaemia by severity in women and children for 2000\u201019: a pooled analysis of population\u2010representative data","volume":"10","author":"Stevens GA","year":"2022","journal-title":"Lancet Glob Health"},{"key":"e_1_2_10_3_1","first-page":"37","article-title":"Anemia, red blood cell transfusion and administration of blood products in obstetrics: a nationwide analysis of more than 6\u2009million cases from 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