Haemovigilance: concepts and frameworks

Background and Objectives This article reviews the principles and objectives of haemovigilance and provides suggestions on important elements to consider in establishing a haemovigilance system. Results Various local, regional and national haemovigilance models exist, reflecting the diversity of health systems and blood systems in different countries. Some systems are coordinated by professional bodies, some by blood suppliers, and others by health authorities. Participation may be voluntary or mandatory, and may differ depending on whether all events or only serious ones are reportable. Some capture events with all levels of imputability, whereas others record only confirmed or highly probable cases. ‘Near miss’ events are captured by some systems, and many valuable lessons can be learned from these. Process-related problems are a major cause of serious transfusion complications. Human and system factors, such as lack of awareness or training, working environment, interruptions and inadequate communications between clinical teams, or between clinical teams and the transfusion laboratory, are important contributors to these events. Investigation of transfusion reactions, incidents and events is essential to identify clinical consequences and contributing factors, and to develop and implement plans to prevent recurrence. Transfusion safety officers and similar roles in many countries are a key part of the haemovigilance team. Adequate medical and transfusion laboratory support for hospital activities is also essential. Hospital transfusion committees should oversee haemovigilance activities and reporting, and ensure that hospital senior management is aware of, and responds to, serious reactions and events, especially where systems issues are contributory. ISBT's Working Party on Haemovigilance brings together ISBT members with an interest in haemovigilance, and works closely with the International Haemovigilance Network, a collaboration of regional or national haemovigilance programmes, for education, data sharing and benchmarking. Conclusion Haemovigilance reporting can identify priority areas for action and monitor the implementation of solutions. An important feature of haemovigilance is the sharing of experiences and results nationally and internationally to improve patient outcomes.