Blood Management Program Reduces Unnecessary Transfusions

Implementing a system-wide patient blood management program (BMP) can substantially reduce blood utilization and blood acquisition costs, claims a new study.

The blood management clinical community, formed at Johns Hopkins University School of Medicine (JHU-SOM; Baltimore, MD, USA), is a physician-led, multidisciplinary, collaborative, quality-improvement team formed in order to implement best practices for patient blood management. To determine the effectiveness of the system, changes in blood utilization and blood acquisition costs were compared for the pre- and post-patient BMP implementation time periods.

The results revealed that across the health system, multiunit erythrocyte transfusion orders decreased from 39.7% to 20.2%, almost half. The percentage of patients transfused decreased for erythrocytes from 11.3% to 10.4%, for plasma from 2.9% to 2.2%, and for platelets from 3.1% to 2.7%. The number of units transfused per 1,000 patients also decreased; for erythrocytes by 19.8%; for plasma by 38.9%; and for platelets by 15.6%. Overall blood acquisition cost savings were USD 2,120,273 per year, an estimated 400% return on investment. The study was published on September 7, 2017, in Anesthesiology.

“Hospitals across the country are merging into health systems, in part to realize economies of scale by improving quality. Our experience with a patient blood management program shows that it's feasible to do that,” said lead author professor of anesthesiology and critical care medicine Steven Frank, MD. “Our premise is that doctors don't want to be told how to practice medicine by computer pop-up alerts; they would rather hear about the studies supporting the guidelines.”

The PBM program was launched in January 2012 at the Johns Hopkins Hospital with a clinical education program that consisted of live, in-person grand rounds presentations to various clinical departments in order to inform physicians, nurses, and other staff about hospital transfusion policy guidelines, and the results of eight published landmark studies that support reduced use of transfusions. The single most effective intervention, according to the study, was the “Why give 2 when 1 will do?" campaign to encourage single-unit transfusions.

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Johns Hopkins University School of Medicine