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Implementation of a patient blood management monitoring and feedback program significantly reduces transfusions and
Tarun Mehra1, Burkhardt Seifert2, Silvina Bravo-Reiter1
1Medical Directorate, University Hospital of Zurich.
Insights
Implementing a patient blood management (PBM) monitoring and feedback program significantly reduced allogeneic blood product transfusions and associated costs. This PBM initiative proved highly effective in optimizing transfusion practices and healthcare economics.
Area of Science:
- Transfusion Medicine
- Healthcare Management
- Patient Safety
Background:
- Patient blood management (PBM) strategies aim to reduce transfusions while maintaining patient outcomes.
- Transfusion guidelines are crucial for PBM success, but their introduction alone did not reduce transfusions in this center.
- A monitoring and feedback program was established to enhance PBM effectiveness.
Purpose of the Study:
- To evaluate the effectiveness of a PBM monitoring and feedback program in reducing blood product transfusions.
- To assess the impact of the PBM program on associated healthcare costs.
Main Methods:
- Prospective, interventional cohort study over 3 years (2012-2014) including 101,794 adult patients.
- Introduction of a PBM monitoring and feedback program with quarterly reporting in January 2014.
- Analysis of transfusion data for allogeneic blood products (red blood cells, platelets, fresh-frozen plasma).
Main Results:
- A 27% reduction in allogeneic blood product transfusions per 1000 patients within the first year of the program.
- Significant decreases in specific blood product units: RBCs (-24%), platelets (-25%), FFP (-37%) (p < 0.001).
- Transfusions per case reduced from 9±19 to 7±14 (p < 0.001), with cost savings over $2 million USD.
Conclusions:
- The PBM monitoring and feedback program was highly effective in reducing allogeneic blood product transfusions.
- The program significantly decreased transfusion-related costs.
- This initiative demonstrates a successful strategy for optimizing blood utilization in healthcare settings.
Background:
Patient blood management (PBM) measures have been shown to be effective in reducing transfusions while maintaining patient outcome. The issuance of transfusion guidelines is seen as being key to the success of PBM programs. As the introduction of guidelines alone did not visibly reduce transfusions in our center, a monitoring and feedback program was established. The aim of our study was to show the effectiveness of such measures in reducing transfusions and cost.
Study Design And Methods:
We designed a prospective, interventional cohort study with a 3-year time frame (January 1, 2012 to December 31, 2014). In total, 101,794 patients aged 18 years or older were included. The PBM monitoring and feedback program was introduced on January 1, 2014, with the subsequent issuance of quarterly reporting.
Results:
Within the first year of introduction, transfusion of all allogeneic blood products per 1000 patients was reduced by 27% (red blood cell units, -24%; platelet units, -25%; and fresh-frozen plasma units, -37%; all p < 0.001) leading to direct allogeneic blood product related savings of more than 2 million USD. The number of blood products transfused per case was significantly reduced from 9 ± 19 to 7 ± 14 (p < 0.001). With an odds ratio of 0.86 (95% confidence interval, 0.82-0.91), the introduction of our PBM monitoring and feedback program was a significant independent factor in the reduction of transfusion probability (p < 0.001).
Conclusion:
Our PBM monitoring and feedback program was highly efficacious in reducing the transfusion of allogeneic blood products and transfusion-related costs.
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