{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T17:48:20Z","timestamp":1782841700896,"version":"3.54.5"},"reference-count":23,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Med Inform"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec sec-type=\"background\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Repeated blood product ordering is associated with order entry errors and potential patient harm. Traditional electronic health record order sets require repeated re-entry for recurrent transfusions, creating inefficiencies and opportunities for error, and contributing to physician burnout. Historically, we have used order sets to order blood products, which must be re-entered each time a transfusion is needed. Reusable transfusion therapy plans may address these challenges by standardizing and streamlining transfusion workflows. We conducted a pre-post study at a single pediatric academic center, evaluating the implementation of reusable transfusion therapy plans for packed red blood cells and platelets in oncology patients and those undergoing hematopoietic stem cell transplantation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"objective\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The primary outcome was to evaluate the proportion of transfusions originating from the transfusion therapy plans during the postimplementation period. Secondary outcomes included evaluating (1) the proportion of eligible patients with applied transfusion therapy plans, (2) changes in transfusion efficiency (time from laboratory result to transfusion release and administration, premedication timing, and estimated overnight pages), and (3) the impact on safety (guideline-concordant dosing, irradiated product ordering, and transfusion thresholds). We also assessed health care practitioner experience using an adaptation of the technology acceptance model survey.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"methods\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The prestudy period consisted of the 1-year preimplementation, and the postperiod consisted of the 1-year post implementation. We used our institution\u2019s enterprise data warehouse (SickKids Enterprise-Wide Data in Azure Repository) to obtain demographic and transfusion details for all eligible patients. The adapted technology acceptance model survey was administered to eligible oncology clinicians.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The preimplementation cohort had 558 unique patients who received a total of 2678 transfusions. The postimplementation cohort had 521 unique patients who received 2777 transfusions. During the postimplementation period, 59% of transfusion orders originated from a therapy plan, increasing to 71% in the final month. Compared with order sets, therapy plan\u2013derived transfusions were released and administered significantly faster following laboratory results (\n                      <jats:italic>P<\/jats:italic>\n                      &lt;.001). Guideline-concordant transfusion volumes increased significantly postimplementation for both packed red blood cells and platelets (\n                      <jats:italic>P<\/jats:italic>\n                      &lt;.001), as did the ordering of irradiated blood products (\n                      <jats:italic>P<\/jats:italic>\n                      &lt;.001). No differences were observed in pretransfusion hemoglobin or platelet thresholds between study periods. Use of therapy plans was associated with an average avoidance of 4 overnight blood product entries per night. Survey responses from nurses and providers demonstrated high perceived usefulness and ease of use, with 95% endorsing continued use.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"conclusions\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Reusable transfusion therapy plans improved efficiency, standardized safe ordering practices, and were highly acceptable to clinicians. This longitudinal, noninterruptive electronic health record intervention represents a scalable approach to supporting high-risk transfusion workflows in pediatric oncology.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2196\/93346","type":"journal-article","created":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T19:01:31Z","timestamp":1778871691000},"page":"e93346-e93346","source":"Crossref","is-referenced-by-count":0,"title":["Implementation and Evaluation of an Alternative Electronic Health Record Tool for Ordering Blood Products in Pediatric Oncology and Stem Cell Transplantation: Mixed Methods 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P","family":"Yan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2026,5,15]]},"reference":[{"issue":"Supplement 1","key":"R1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2024-203534","article-title":"Exploring physician-related transfusion errors reported to the Transfusion Error Surveillance System (TESS) from 2016-2023: a single centre study","volume":"144","author":"Lou","journal-title":"Blood"},{"issue":"1","key":"R2","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1111\/trf.12240","article-title":"Hospital-based transfusion error tracking from 2005 to 2010: identifying the key errors threatening patient transfusion safety","volume":"54","author":"Maskens","journal-title":"Transfusion"},{"issue":"4","key":"R3","doi-asserted-by":"publisher","first-page":"240","DOI":"10.1159\/000453320","article-title":"Administration safety of blood products\u2014lessons learned from a 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