SAN DIEGO: Improving the processes of ordering, transporting, and storing blood can save millions of dollars and drastically reduce blood wastage, reported a research team from one academic medical center after implementing institutional initiatives to address blood management. The multidisciplinary team at Vanderbilt University Medical Center, Nashville, Tenn., developed blood utilization practice guidelines that resulted in $2 million in savings and a 30 percent reduction in blood utilization, according to a poster presentation at the 2016 American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP®) Conference in San Diego.
“The transfusion committee at Vanderbilt was interested in evaluating how we could implement evidence-based guidelines around restrictive transfusion,” according to lead study author Barbara J. Martin, MBA, RN.
The first step the team at Vanderbilt took to better utilize blood transfusion practices was to change provider orders to support a single unit and then follow up and order more blood if necessary. The previous standard process was to initially order two units of blood, which is not always needed. Study authors noted that it is common practice at many hospitals to reflexively order a transfusion based on habit, rather than assessment.
According to study authors, blood transfusions increase the risk of complications–including transfusion reaction, infection, volume overload, increased length of stay, and, even, mortality–associated directly and indirectly with the transfusion.
“The data on restrictive transfusion has been out for years documenting that patients have better outcomes with a more restrictive transfusion strategy. We were looking at whether we could guide providers to treat symptomatic anemia with a single unit of blood rather than the usual two units,” Ms. Martin said.
By enhancing the Computerized Provider Order Entry (CPOE), the research team allowed for blood ordering practices to be based on a specific assessment of each case rather than a …