Optimizing the cost-effectiveness of quality assurance in transfusion medicine.

Although quality assurance efforts have been integrated into many aspects of American health care, their value has been questioned. They can consume large amounts of resources (monetary and/or temporal), calling into question their cost-effectiveness. To improve the yield of quality assurance efforts and limit their consumption of administrative resources, they need to be focused on those aspects of the operation where improvement is needed or where errors are particularly problematic and costly. Just as a quality assurance program needs to define the outcome required of the process being monitored, the outcome of the quality assurance process needs to be defined at the outset; the simplest possible system should then be designed to capture the necessary data to direct improvement. Although quality assurance efforts have been documented to yield substantial savings, their real payback is provided through better control of an operation and more complete knowledge of the status of that operation.