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Table 1 Problems, root causes, and change ideas identified during the diagnostic phase

From: Improving the treatment of pre-operative anemia in hepato-pancreato-biliary patients: a quality improvement initiative

Problem

Root Cause

Change Idea

Current algorithm is too complicated

Etiology of anemia can be multifactorial

Re-design the algorithm

Ordering of blood work is unclear

Blood work is required at multiple points in the patient journey

Simplify to CBC and ferritin

Unclear to whom to refer

Multiple programs (medicine, hematology, SBMP)

Designate SBMP as the sole referral destination

Optimal oral iron prescription is unknown

Surgeons do not routinely treat anemia

Create standardized prescriptions