Juskewitch, Justin E

AbstractBackgroundPlatelet (PLT) transfusion refractoriness increases bleeding complications, hospital stays, and PLT inventory usage. Immune‐mediated refractoriness can be evaluated for using a physical PLT crossmatch with ABO‐compatible inventory and, if positive, managed with HLA‐compatible PLT inventory and donors. Manual completion of these complex tasks can be time‐consuming and potentially error‐prone. This study was conducted to determine if a Web‐based software application could improve process efficiency and accuracy.Study Design and MethodsWorkflow analysis was performed to identify process, data, and analytic requirements for a software application for three PLT transfusion‐refractoriness associated tasks: (a) physical PLT crossmatch inventory selection, (b) HLA‐compatible inventory selection, and (c) HLA‐compatible donor selection. After software application development, a comparison study was performed over 10 consecutive days, with each task performed manually and with the software application (Platelet Virtual Crossmatch [PLT VXM]) for a different unique immune‐mediated PLT transfusion–refractory recipient. Task completion time, number of incompatible units/donors presented, and number of documentation errors were compared.ResultsPLT VXM is a Web‐based software application developed using R and the Shiny Web application framework. PLT VXM significantly reduced median task completion times by 4.5 (49%), 11.2 (79%), and 59.1 minutes (94%), respectively. PLT VXM did not present any incompatible PLT units or donors for user consideration. PLT VXM also had a lower number of documentation errors than the manual process, and none of these documentation errors were software generated.ConclusionComputer‐aided evaluation and management of immune‐mediated PLT transfusion–refractory recipients can significantly improve workflow and reduce manual errors in this complex process.