We thank all of the hospitals and transfusion departments and teams who participated in this programme and our contributors to the PPI panel. We acknowledge the specific work of the audit leads across the two audit cycles (Dr K Pendry, Dr S Allard, Dr J Burchill and Dr M Karakantza), and thank Professor M Murphy for constructive input into early stages of the programme development. Isabelle Smith, Thomas Morris, Zoe Craig and Ellen Mason contributed to the analysis in WS2 and Karla Diaz-Ordaz contributed to the statistical analysis plan for WS2. We would also like to acknowledge Tasneem Khan, NIHR Academic Clinical Fellow in General Practice, who co-designed, conducted and co-analysed the ‘audit of audits’ survey.
Contributions of authors
Robbie Foy (https://orcid.org/0000-0003-0605-7713) co-led workstream 2 and led workstream 4.
Fabiana Lorencatto (https://orcid.org/0000-0003-4418-7957) and Natalie Gould conducted the interview work and process evaluation.
Rebecca Walwyn (https://orcid.org/0000-0001-9120-1438) was the statistical lead.
Jill Francis (https://orcid.org/0000-0001-5784-8895) led workstreams 1 and 3.
Stephen McIntyre (https://orcid.org/0000-0001-9394-8914), Riya Patel (https://orcid.org/0000-0001-6572-5924), James Smith (https://orcid.org/0000-0002-0448-8774), Camilla During and Jon Bird (https://orcid.org/0000-0002-1681-1532) contributed to programme and trial data collection and analysis.
Suzanne Hartley (https://orcid.org/0000-0003-2346-9461) was responsible for operational delivery of the trials.
Robert Cicero (https://orcid.org/0000-0002-3713-2934) contributed to the randomisation and analysis, with guidance from Rebecca Walwyn and Amanda Farrin (https://orcid.org/0000-0002-2876-0584).
Liz Glidewell (https://orcid.org/0000-0003-2519-2654) provided support for analysis of contamination effects and support for PPI.
John Grant-Casey (https://orcid.org/0000-0001-5166-4550) managed the National Comparative Audit programme in transfusion alongside the conduct of the trials, with support from Megan Rowley (https://orcid.org/0000-0002-9322-8527) and Simon J Stanworth.
Alison Deary (https://orcid.org/0000-0001-8351-4186) advised on governance and data acquisition and programme financial support.
Nicholas Swart (https://orcid.org/0000-0001-8343-766X) with guidance from Stephen Morris (https://orcid.org/0000-0002-5828-3563) conducted the economic evaluation.
Michelle Collinson (https://orcid.org/0000-0003-3568-6455) led the statistical programming for the enhanced content intervention.
Lauren Moreau (https://orcid.org/0000-0002-0280-6345) provided invaluable administration support.
Susan Michie (https://orcid.org/0000-0003-0063-6378) and Jeremy M Grimshaw (https://orcid.org/0000-0001-8015-8243) provided overall programme direction and advice at multiple steps.
Simon J Stanworth was principal investigator for the programme and co-led workstream 2.
Publications
Gould NJ, Lorencatto F, Stanworth SJ, Michie S, Prior ME, Glidewell L, et al. Application of theory to enhance audit and feedback interventions to increase the uptake of evidence-based transfusion practice: an intervention development protocol. Implement Sci 2014;9:92. https://doi.org/10.1186/s13012-014-0092-1
Lorencatto F, Gould NJ, McIntyre SA, During C, Bird J, Walwyn R, et al. A multidimensional approach to assessing intervention fidelity in a process evaluation of audit and feedback interventions to reduce unnecessary blood transfusions: a study protocol. Implement Sci 2016;11:163. https://doi.org/10.1186/s13012-016-0528-x
Hartley S, Foy R, Walwyn REA, Cicero R, Farrin AJ, Francis JJ, et al. The evaluation of enhanced feedback interventions to reduce unnecessary blood transfusions (AFFINITIE): protocol for two linked cluster randomised factorial controlled trials. Implement Sci 2017;12:84. https://doi.org/10.1186/s13012-017-0614-8
Gould NJ, Lorencatto F, During C, Rowley M, Glidewell L, Walwyn R, et al. How do hospitals respond to feedback about blood transfusion practice? A multiple case study investigation. PLOS ONE 2018;13. https://doi.org/10.1371/journal.pone.0206676
Grimshaw JM, Ivers N, Linklater S, Foy R, Francis JJ, Gude WT, et al. Reinvigorating stagnant science: implementation laboratories and a meta-laboratory to efficiently advance the science of audit and feedback. BMJ Qual Saf 2019;28:416–23. https://doi.org/10.1136/bmjqs-2018-008355
Stanworth SJ, Lorencatto F, Gould N, Grant-Casey J, Deary A, Hartley S, et al. Can we do better? Bridging the research to practice gap in patient blood management–optimizing ‘audit & feedback’ and the challenges of undertaking a national cluster-randomized controlled trial. VOXS 2019;14:129–35.
Stanworth SJ, Walwyn R, Grant-Casey J, Hartley S, Moreau L, Lorencatto F, et al.; AFFINITIE Collaborators. Effectiveness of enhanced performance feedback on appropriate use of blood transfusions: a comparison of 2 cluster randomized trials. JAMA Netw Open 2022;5:e220364. https://doi.org/10.1001/jamanetworkopen.2022.0364
Data-sharing statement
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Patient data
This work uses data provided by patients and collected by the NHS as part of their care and support. Using patient data is vital to improve health and care for everyone. There is huge potential to make better use of information from people’s patient records, to understand more about disease, develop new treatments, monitor safety, and plan NHS services. Patient data should be kept safe and secure, to protect everyone’s privacy, and it’s important that there are safeguards to make sure that it is stored and used responsibly. Everyone should be able to find out about how patient data are used. #datasaveslives You can find out more about the background to this citation here: https://understandingpatientdata.org.uk/data-citation.
Disclaimers
This report presents independent research funded by the National Institute for Health Research (NIHR). The views and opinions expressed by authors in this publication are those of the authors and do not necessarily reflect those of the NHS, the NIHR, CCF, NETSCC, PGfAR or the Department of Health and Social Care. If there are verbatim quotations included in this publication the views and opinions expressed by the interviewees are those of the interviewees and do not necessarily reflect those of the authors, those of the NHS, the NIHR, NETSCC, the PGfAR programme or the Department of Health and Social Care.