title: Massive Transfusion Protocol:  Communication Ordering Practice Survey (MTP COPS).
abstract: OBJECTIVE
  We sought to assess ordering practices and quality of communication during massive transfusion at US level I trauma centers.
  
  
  METHODS
  An anonymous, web-based survey was distributed to blood banks supporting US level I trauma centers. Information gathered in the survey included demographics, utilization of and perceived level of support for computerized physician order entry (CPOE), frequency of order confusion, and nonprotocol ordering. Responses were analyzed using descriptive statistics.
  
  
  RESULTS
  Responses were received from 43 of 121 centers (35.5% response rate), with the majority completed by blood bank physicians (67.4%) and blood bank supervisors (25.6%). Allowable pathways for massive transfusion protocol (MTP) ordering included CPOE (48.8%), verbal/telephone (86.1%), and written (44.2%). The preferred method of MTP activation was verbal/telephone (86.1%). Initial activation of MTP was well communicated (97.6% agreement), but confusion associated with ongoing needs was reported to occur at least sometimes by 32.6%.
  
  
  CONCLUSIONS
  Although CPOE-based MTP ordering is offered by nearly half of US level I trauma centers, verbal/telephone ordering is by far the preferred mechanism. Our survey identifies confusion surrounding blood component needs during MTP resuscitation as an opportunity for practice improvement.
authors: From the University of California Irvine Health, School of Medicine, Irvine minhhat1@uci.edu.
authors: Minh-Ha
authors: MH
authors: Tran
authors: Columbia University Medical Center, New York, NY.
authors: Sarah
authors: S
authors: Vossoughi
authors: University of Vermont College of Medicine, Burlington.
authors: Sarah
authors: S
authors: Harm
authors: Dartmouth-Hitchcock Medical Center, Lebanon, NH.
authors: Nancy
authors: N
authors: Dunbar
authors: University of Vermont College of Medicine, Burlington.
authors: Mark
authors: M
authors: Fung
mesh_terms: D001771:Blood Banks / Q000458:organization & administration*; D001803:Blood Transfusion / Q000379:methods*; D002985:Clinical Protocols; D019538:Health Care Surveys; D006801:Humans; D014193:Trauma Centers / Q000458:organization & administration*
keywords: Damage control resuscitation; Fixed-ratio transfusion; Level I trauma center; Massive transfusion; Massive transfusion protocol; Resuscitation; Trauma