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Optimizing medical practice using a computerized hospital information system. Example of blood transfusions
E Lepage1, R M Gardner, R M Laub
1Département de Biostatique et Informatique Médicale, Hôpital Saint-Louis, Paris, France.
Nouvelle Revue Francaise D'Hematologie
|January 1, 1990
Summary
Physicians need better transfusion therapy knowledge. A computerized system screened blood transfusion requests, with 90% meeting criteria, indicating a need for improved physician education on blood product optimization.
Area of Science:
- Transfusion Medicine
- Health Informatics
- Patient Safety
Background:
- Increasing focus on medical risks and costs associated with blood transfusions necessitates clear transfusion guidelines.
- A computerized knowledge-based system was implemented at LDS Hospital in 1987 to manage transfusion requests.
- The system screens requests against criteria defined by medical staff to ensure appropriate use of blood products.
Purpose of the Study:
- To review the utilization of red blood cells (RBC) over a nine-month period.
- To assess the effectiveness of the computerized system in screening transfusion requests.
- To identify areas for improvement in physician knowledge regarding transfusion therapy.
Main Methods:
- Review of red blood cell (RBC) utilization data from July 1, 1988, for a nine-month period.
- Analysis of transfusion requests screened by the computerized knowledge-based system at LDS Hospital.
- Evaluation of the percentage of RBC units ordered that met established transfusion criteria.
Main Results:
- The computerized system flagged transfusion requests based on predefined medical staff criteria.
- Approximately 90% of the red blood cell (RBC) units ordered during the study period met the hospital's criteria.
- The results indicated a gap in physician knowledge concerning optimal transfusion therapy.
Conclusions:
- While the system screened most requests, 10% did not meet criteria, highlighting potential for improvement.
- There is a clear need to refine medical staff knowledge and education on transfusion therapy.
- Optimizing the use of blood products requires ongoing education and adherence to evidence-based guidelines.