Abstract: Objective To explore the practical value of using unplanned massive transfusion as a quality evaluation indicator in clinical blood use management. Methods A before and after study design was employed to establish a scientific cycle of “assessment-intervention-reassessment.” Using the clinical blood usage records of Beijing Tiantan Hospital, Capital Medical University, from 2023 to 2024, we systematically collected all cases of unplanned massive transfusion as study subjects. A controlled study was conducted, with cases from 2023 serving as the baseline control group (pre-intervention) and cases from 2024 as the intervention group. Data from both groups were analyzed to evaluate the effects of implementing “unplanned massive transfusion” as a key quality indicator on reducing total blood consumption, optimizing transfusion processes, and decreasing the incidence of adverse events. Results Following the implementation of improvement measures—including adopting unplanned massive transfusion as a quality indicator, strengthening pre-operative assessment and approval, and enhancing training and assessment for medical staff in 2024—a positive outcome was recorded even an increase in both the total number of surgeries and their complexity during this period. The number of massive transfusion cases decreased by 31.7% (71 vs. 104), the number of unplanned massive transfusion cases decreased by 37.5% (45 vs. 72). Overall blood consumption was reduced by 10.9%. Conclusions Application of unplanned massive transfusion as a quality evaluation indicator for continuous improvement in clinical blood use management is feasible and can enhance both quality and efficiency of blood transfusion management in hospitals.

Key words: unplanned massive transfusion, clinical blood safety management