{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T02:39:36Z","timestamp":1792377576039,"version":"4.4.0"},"reference-count":19,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T00:00:00Z","timestamp":1792281600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T00:00:00Z","timestamp":1792281600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transfusion"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Transfusion reactions are underreported, with reported rates up to 87% lower than expected for serious reactions such as transfusion\u2010associated circulatory overload (TACO). We implemented a multicomponent quality improvement initiative to improve recognition and reporting of transfusion reactions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study design and methods<\/jats:title>\n                    <jats:p>The initiative combined standardized nursing education with an electronic medical record (EMR)\u2010integrated structured workflow, the Care Signature Transfusion Reaction Pathway, to standardize recognition, evaluation, and management of suspected reactions. We also developed an automated transfusion reaction dataset to retrospectively audit transfusion events and identify reactions not captured through routine reporting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Transfusion reaction education was incorporated into the institutional learning management system for nursing staff. During its initial six\u2010month rollout, the Care Signature Transfusion Reaction Pathway was accessed 258 times. Retrospective surveillance identified 36 previously unreported reactions across the health system, including 22 TACO cases. Combined with the 17 TACO reactions reported to the blood banks, these additional cases represented a 129% increase in TACO identification. Following implementation, the overall transfusion reaction reporting rate at the index site increased from 0.627% to 0.683%, and the TACO identification rate increased by 293%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A multicomponent intervention comprising standardized nursing education, an EMR\u2010integrated transfusion reaction pathway, and automated retrospective surveillance improved transfusion reaction recognition and reporting. The intervention identified 36 previously unreported reactions, particularly TACO, and increased TACO identification both across the health system and at the index site. This approach used existing health\u2010system infrastructure to enhance surveillance across diverse hospital settings and may be scalable to other health systems.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/trf.70449","type":"journal-article","created":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T01:45:41Z","timestamp":1792374341000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Quality improvement program for transfusion reaction reporting and management"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-8637-3560","authenticated-orcid":false,"given":"Erica","family":"Martel","sequence":"first","affiliation":[{"name":"Department of Internal Medicine Bridgeport Hospital  Bridgeport Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth","family":"Forte","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Bridgeport Hospital  Bridgeport Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4271-0644","authenticated-orcid":false,"given":"Elizabeth","family":"Tremblay","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine Yale School of Medicine  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andriana","family":"Foiles","sequence":"additional","affiliation":[{"name":"Research and Library Services Bridgeport Hospital  Bridgeport Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5877-1244","authenticated-orcid":false,"given":"Cheryl","family":"Green","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Bridgeport Hospital  Bridgeport Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Todd","family":"Lane","sequence":"additional","affiliation":[{"name":"Research and Library Services Bridgeport Hospital  Bridgeport Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Krause","sequence":"additional","affiliation":[{"name":"Department of Pathology Bridgeport Hospital  Bridgeport Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheyla","family":"Marranca","sequence":"additional","affiliation":[{"name":"Information Technology Services Yale New Haven Health System  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-2224-6935","authenticated-orcid":false,"given":"Wei","family":"Teng","sequence":"additional","affiliation":[{"name":"Information Technology Services Yale New Haven Health System  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1785-2245","authenticated-orcid":false,"given":"Christopher A.","family":"Tormey","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine Yale School of Medicine  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward L.","family":"Snyder","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine Yale School of Medicine  New Haven Connecticut USA"},{"name":"Department of Pathology Bridgeport Hospital  Bridgeport Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7807-6046","authenticated-orcid":false,"given":"Nalan","family":"Yurtsever","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine Yale School of Medicine  New Haven Connecticut USA"},{"name":"Department of Pathology Bridgeport Hospital  Bridgeport Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,18]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"crossref","first-page":"1866","DOI":"10.1111\/trf.13060","article-title":"Variation in vital signs resulting from blood component administration in adults","volume":"55","author":"Gehrie EA","year":"2015","journal-title":"Transfusion"},{"key":"e_1_2_8_3_1","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1111\/vox.12621","article-title":"A multicentre study investigating vital sign changes occurring in complicated and uncomplicated transfusions","volume":"113","author":"Gehrie EA","year":"2018","journal-title":"Vox Sang"},{"key":"e_1_2_8_4_1","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1111\/vox.13396","article-title":"Should adding pain, oxygen saturation and physical assessment to vital signs become the new standard of care for detecting blood transfusion reactions?","volume":"118","author":"Roney JK","year":"2023","journal-title":"Vox Sang"},{"key":"e_1_2_8_5_1","doi-asserted-by":"crossref","first-page":"2587","DOI":"10.1111\/trf.13730","article-title":"Incidence of transfusion reactions: a multicenter study utilizing systematic active surveillance and expert adjudication","volume":"56","author":"Hendrickson JE","year":"2016","journal-title":"Transfusion"},{"key":"e_1_2_8_6_1","article-title":"Knowledge, attitude, and practice regarding adverse transfusion reactions among nurses, physicians, and transfusion specialists in China: a multicenter cross\u2010sectional survey","volume":"19","author":"Hu T","year":"2026","journal-title":"J Multidiscip Healthc"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.70342"},{"key":"e_1_2_8_8_1","doi-asserted-by":"crossref","first-page":"1019","DOI":"10.1111\/trf.16880","article-title":"Analyzing real world data of blood transfusion adverse events: opportunities and challenges","volume":"62","author":"Jhaveri P","year":"2022","journal-title":"Transfusion"},{"key":"e_1_2_8_9_1","doi-asserted-by":"crossref","first-page":"1950","DOI":"10.1111\/trf.15931","article-title":"Early recognition of possible transfusion reactions using an electronic automatic notification system for changes in vital signs in patients undergoing blood transfusions","volume":"60","author":"Lim YA","year":"2020","journal-title":"Transfusion"},{"key":"e_1_2_8_10_1","doi-asserted-by":"crossref","first-page":"1708","DOI":"10.1111\/trf.14769","article-title":"Enhancing hemotherapy safety through pertinent diagnostic testing and electronic \u201cprovisional diagnosis\u201d reporting: expanding roles for blood bank technologists in biovigilance and patient safety","volume":"58","author":"Andrzejewski C","year":"2018","journal-title":"Transfusion"},{"key":"e_1_2_8_11_1","doi-asserted-by":"crossref","first-page":"1010","DOI":"10.1111\/trf.16882","article-title":"Digitally enabled hemovigilance allows real time response to transfusion reactions","volume":"62","author":"Villamin C","year":"2022","journal-title":"Transfusion"},{"key":"e_1_2_8_12_1","doi-asserted-by":"crossref","DOI":"10.1186\/s12911-025-03232-z","article-title":"Artificial intelligence in the identification and prediction of adverse transfusion reactions(ATRs) and implications for clinical management: a systematic review of models and applications","volume":"25","author":"ShojaeiBaghini M","year":"2025","journal-title":"BMC Med Inform Decis Mak"},{"key":"e_1_2_8_13_1","doi-asserted-by":"crossref","first-page":"1859","DOI":"10.1111\/trf.17538","article-title":"Transfusion\u2010associated adverse events incidence and severity after the implementation of an active hemovigilance program with 24 h follow\u2010up. A prospective cohort study","volume":"63","author":"Bueno JL","year":"2023","journal-title":"Transfusion"},{"key":"e_1_2_8_14_1","doi-asserted-by":"crossref","first-page":"2898","DOI":"10.1111\/trf.13228","article-title":"Evaluation of the in\u2010hospital hemovigilance by introduction of the information technology\u2010based system","volume":"55","author":"Fujihara H","year":"2015","journal-title":"Transfusion"},{"key":"e_1_2_8_15_1","doi-asserted-by":"crossref","first-page":"2029","DOI":"10.1111\/trf.17069","article-title":"Detection of allergic transfusion\u2010related adverse events from electronic medical records","volume":"62","author":"Whitaker B","year":"2022","journal-title":"Transfusion"},{"key":"e_1_2_8_16_1","volume-title":"Fatalities reported to FDA following blood collection and transfusion: annual summary for FY 2020","author":"U.S. Food and Drug Administration, Center for Biologics Evaluation and Research (CBER)","year":"2021"},{"key":"e_1_2_8_17_1","doi-asserted-by":"crossref","first-page":"1831","DOI":"10.1182\/blood-2018-10-833988","article-title":"Noninfectious transfusion\u2010associated adverse events and their mitigation strategies","volume":"133","author":"Goel R","year":"2019","journal-title":"Blood"},{"key":"e_1_2_8_18_1","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1093\/ajcp\/aqaa279","article-title":"Transfusion\u2010associated circulatory overload and transfusion\u2010related acute lung injury","volume":"156","author":"Akker TA","year":"2021","journal-title":"Am J Clin Pathol"},{"key":"e_1_2_8_19_1","doi-asserted-by":"crossref","first-page":"929","DOI":"10.1038\/s41372-018-0100-4","article-title":"Introduction to quality improvement tools for the clinician","volume":"38","author":"Picarillo AP","year":"2018","journal-title":"J Perinatol"},{"key":"e_1_2_8_20_1","volume-title":"National Healthcare Safety Network biovigilance component hemovigilance module surveillance protocol","author":"Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention","year":"2023"}],"container-title":["Transfusion"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/trf.70449","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/trf.70449","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/trf.70449","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T01:45:44Z","timestamp":1792374344000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/trf.70449"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,18]]},"references-count":19,"alternative-id":["10.1111\/trf.70449"],"URL":"https:\/\/doi.org\/10.1111\/trf.70449","archive":["Portico"],"relation":{},"ISSN":["0041-1132","1537-2995"],"issn-type":[{"value":"0041-1132","type":"print"},{"value":"1537-2995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,18]]},"assertion":[{"value":"2026-06-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-09","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-18","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"trf.70449"}}