Proper Medical Prescriptions and Cord Blood Harvesting Improvement at a Children’s Hospital of North Eastern Italy

A systematic harvesting of hematopoietic progenitor cells for transplant purpose in oncology begun in Friuli Venetia Giulia (FVG), a region of north east Italy, at the end of 2000. The actual economic crisis in Italy and in all Europe slows down number births and the cord blood related collection, because tests’ ticket during pregnancy and medical visits are many expensive; nevertheless some specific medical prescriptions and test during pregnancy are exempt from tickets in public health, but not all doctors and patients know rules and modalities of exemption in obstetric-gynecology. Moreover there are formal errors due to the bad quality of external quality control (EQC) of some tests useful to the validation of the cord blood collection. The aim of this work is to study the impact of formal errors in prescriptions and tests validation at a Children’s Hospital of Trieste (main town of FVG region). To this aim had been performed a monitoring, during 2013-14s, to improve appropriateness of prescriptions related to stem cells collection and to make more suitable and safe transplants and related medical cares.3300 medical prescriptions were monitored for 24 months (from 2013 January to 2015 December), and studied with a χ2 test before and after analysis not in compliance with activities and was introduced a management protocol of improvement: the external quality assessment (EQA) of the tests was performed by Biodev (Milan, Italy). Results. The comparison of prescriptions and external tests during 2014-15s has highlighted a significant decreasing of not appropriate requests, mistakes of prescriptions about obstetric exemptions (p<0.05), with a improvement of cord blood harvesting and a re-entry of EQA in the first or second SD. These data stress the continuous use of the sanitary activities monitoring, with updated protocols and severe controls, as key points to improve cares and to avoid improper costs in public health.