The success of our patient blood management program depended on an institution‐wide change in transfusion practices

Abstract

Our success was achieved through hospital-wide physician buy-in toward a restrictive transfusion approach. We hope to encourage others to consider PBM for improved patient outcomes and blood conservation.

Is there a “magic” hemoglobin number? Clinical decision support promoting restrictive blood transfusion practices

“…The proportion of 2-unit RBC transfusions decreased from 47% before to 15% after this intervention [96]. A second center similarly reported a reduction in 2-unit RBC orders (48% to 33%) and an increase in 1-unit RBC transfusions (22-48%), before and after, respectively, implementing a comprehensive education and audit program promoting restrictive transfusion practices [97]. A recent literature review found that while CDS can improve RBC usage, further data are needed to assess whether CDS can improve plasma and platelet use utilization [98].…”

The Impact of Electronic Decision Support on Transfusion Practice: A Systematic Review

“…After full texts were examined, 24 records were judged to be eligible. Fourteen records excluded after examining full texts are shown in Supplementary Table S2 [32][33][34][35][36][37][38][39][40][41][42][43][44][45].…”

Patient Blood Management Bundles to Facilitate Implementation

“…To optimize utilization of blood products and to identify the ordering physician in case of any audit, it is beneficial to adopt a physician order entry with a clinical decision support based on electronic medical records [14,17]. For the purposes of obtaining informed consent from a patient for the transfusion of allogeneic blood products before transfusion (or after it, when urgently needed), handwritten or computer-generated forms (ideally a separate sheet of paper) should be used that comprehensively includes a detailed outline of transfusion benefits, risks, and alternatives.…”

“…There is a large amount of research evidence that the successful implementation of PBM reduces perioperative blood loss and transfusion needs [13][14][15][16][17][18][19][20], perioperative morbidity [13,16], mortality [14,16], length of hospital stay [14,16], and costs [21]. In this respect, the World Health Organization has officially been urging member states to implement PBM since 2010 (WHA63.12).…”

“…In this respect, the World Health Organization has officially been urging member states to implement PBM since 2010 (WHA63.12). Patient blood management programs have already been rolled out successfully in some hospitals in Western Australia [19], Europe [13,18], United States [14,17], and now starting in Asia. Notable, outside Australia, no national PBM programs have been established, and many hospitals worldwide seek guidance with its implementation.…”