8 July 2022
Quality Use of Pathology Program (QUPP):
Quality use of non-invasive prenatal RhD testing
Dear Colleague,
I am incredibly excited to announce the Society has been awarded a $352,000 grant from The Department of Health and Aged Care Quality Use of Pathology Program (QUPP). This is a national grants program that aims to improve health and economic outcomes through best practice use of pathology testing.
Success in being awarded this QUPP grant represents a significant achievement for our Society. This is also an important milestone for us with acknowledgement by the Australian Government of the Society’s key role as advocates for safe, appropriate and effective transfusion practice.
Our project is titled Quality use of non-invasive prenatal RhD testing with the outcome of achieving a standardised and optimised clinical RhD testing pathway applicable and available nationally, to meet the needs of general practitioners, obstetricians, midwives, pathologists and pregnant women. The underlying aim is to support the effective implementation of Medicare-funded RHD non-invasive prenatal testing and ensure RhD immunoglobulin prophylaxis is appropriate and in accordance with the new National Blood Authority (NBA) guidelines.
The project will be managed by a Steering Committee supported by a Project Manager and Project Officer.
Expressions of interests from Members
Members are invited to submit expressions of interest for the Project Manager or Project Officer roles.
The Project Manager will require business analytical skills and would be involved in high-level process mapping.
The Project Officer will be involved in extracting data and planning.
Both roles would expect significant communication with stakeholders.
These positions would be up to full time for 12 months.
For further information, please contact the ANZSBT Secretariat on 0411 441 296 or anzsbt@anzsbt.org.au
The Project
There are approximately 300,000 births in Australia annually, of which 15% (45,000) are to RhD negative women. Currently, all RhD negative women without preformed anti-D antibodies receive prophylactic RhD immunoglobulin (RhD Ig) during pregnancy (at 28 and 34 weeks gestation) to reduce the risk of sensitisation to fetal RhD positive red cells. Only 65% of these fetuses will be RhD positive, meaning that approximately 16,000 RhD negative women receive RhD Ig unnecessarily when not carrying a RhD positive fetus.
The National Blood Authority (NBA) has recognised this as potentially unsustainable from a supply perspective. They have introduced new guidance that recommends prenatal testing on a maternal blood sample to be performed from 11 weeks gestation to determine the RHD genetic status of the fetus for all RhD negative women.
Identification of fetuses predicted to be RhD positive will lead to targeted administration of prophylactic RhD Ig. This will reduce unnecessary use of a scarce blood product, conserving supplies for those for whom it is essential. Implementation necessitates a systematic approach to pathology testing.
This project will identify all steps in the pathology testing process for RhD negative women. It will map all processes from patient identification, requesting information, sample collection and transport, laboratory information systems and result reporting. Staff training, education and communication and quality assurance will also be incorporated.
The outcome will be a standardised and optimised clinical testing pathway applicable and available nationally, to meet the needs of health care professionals and the community. This will result in effective implementation of Medicare-funded RHD non-invasive prenatal testing and ensure use of RhD Ig prophylaxis is appropriate and in accordance with the NBA Guidance.
Implementation of a standardised approach to pre- and post-analytical pathology testing will build upon strong foundations in prevention of haemolytic disease of the fetus and newborn and its devastating consequences , while simultaneously minimising the demands on the small number of dedicated RhD Ig program donors.
I hope you’ll agree this a fantastic initiative for our Society.
Simon Benson
ANZSBT PRESIDENT