RT Journal Article SR Electronic T1 Improving patient blood management in obstetrics: snapshots of a practice improvement partnership JF BMJ Quality Improvement Reports JO BMJ Qual Improv Report FD British Medical Journal Publishing Group SP e000009 DO 10.1136/bmjquality-2017-000009 VO 6 IS 1 A1 Cindy J Flores A1 Farah Sethna A1 Ben Stephens A1 Ben Saxon A1 Frank S Hong A1 Trish Roberts A1 Tracey Spigiel A1 Maria Burgess A1 Belinda Connors A1 Philip Crispin YR 2017 UL http://bmjopenquality.bmj.com/content/6/1/e000009.abstract AB Iron deficiency and anaemia are common in pregnancy. Audit data from our tertiary obstetrics unit demonstrated 22% of maternity patients experiencing a postpartum haemorrhage received a transfusion; a third of whom were anaemic on admission intrapartum. Australian Patient Blood Management (PBM) Module 5 Obstetrics guidelines focuses on maximising red cell mass at the time of delivery and reducing the reliance on transfusion as a salvage therapy to treat blood loss. A clinical practice improvement partnership began in February 2015 and completed in April 2016; which aimed to implement systems to improve antenatal identification and management of iron deficiency, and improve postpartum anaemia management. In order to develop change strategies, reasons for poor detection and correction of iron deficiency in the antenatal period were identified following a quality improvement methodology. Education was delivered to maternity healthcare providers. Standardised algorithms and an oral iron prescription handout were developed and piloted. Follow-up audit, staff and patient feedback, and other hospital data were collected to measure outcomes. The rate of anaemia on admission intrapartum fell from 12.2% in 2013 to 3.6% in 2016 following the introduction of unselective ferritin screening and other antenatal interventions. Sixty to 70% of maternity patients screened each month had iron deficiency. The algorithms aided staff to become confident in blood test interpretation and management of iron deficiency and anaemia. Patients found the oral iron prescription handout helpful. Additionally, single unit transfusions significantly increased from 35.4% to 50% (p=0.037) over the project timeframe. This project demonstrated the potential to improve patient blood management in obstetrics, reduce anaemia and transfusions by active antenatal interventions.