• Inelda Gjata, Lori Olivieri, Leyla Baghirzada, EndersbyRyan V WRVWDepartment of Anesthesiology, Perioperative and Pain Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada., Nathan M Solbak, Colin G W Weaver, Sampson Law, Lara J Cooke, Kelly W Burak, and Shawn K Dowling.
• Physician Learning Program, Continuing Medical Education and Professional Development, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
• Can J Anaesth. 2022 Sep 1; 69 (9): 112911381129-1138.

PurposeIntraoperative tranexamic acid (TXA) is used to reduce blood loss and the need for transfusions following total hip arthroplasty (THA) and total knee arthroplasty (TKA). Despite evidence in literature and local practice protocols supporting TXA as a part of standard of care for joint arthroplasty, TXA administration is underutilized. We aimed to use group-facilitated audit and feedback as the foundation of a knowledge translation strategy to increase TXA use for THA and TKA procedures.MethodsAnesthesiologists consented to receive two data reports summarizing their individual rates of TXA use and postoperative blood transfusions compared with site peers. Variables collected included patient demographics, TXA usage, and the frequency and volume of red blood cell transfusions administered in the 72-hr postoperative period. The facilitated feedback session discussed report findings and focused on factors contributing to local practice patterns and opportunities for change.ResultsTranexamic acid use increased for THA procedures at the intervention site from 66.6 to 74.4% (absolute change, 7.9%; 95% confidence interval [CI], 2.4 to 13.3). Likewise, TXA use for TKA procedures increased from 62.4 to 82.3% (absolute change, 19.9%; 95% CI 15.0 to 25.0).ConclusionsPhysicians and their teams were able to review their practice data on TXA utilization, reflect on differences compared with evidence-based guidelines, discuss findings with peers, and identify opportunities for improvement. The intervention increased the use of TXA for both TKA and THA and shifted the dosage to better align with evidence-based practice guidelines.© 2022. Canadian Anesthesiologists' Society.

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