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Perioperative blood ordering optimization process using information from an anesthesia information management system.

Joseph B Rinehart1, Tiffany C Lee1, Kayleigh Kaneshiro1

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Implementing a maximum surgical blood order schedule (MSBOS) reduced unnecessary preoperative blood testing and saved costs. This evidence-based approach optimized blood ordering practices in surgical settings.

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Area of Science:

  • Anesthesiology
  • Transfusion Medicine
  • Healthcare Management

Background:

  • Perioperative surgical home initiatives aim to optimize patient care and reduce costs.
  • A previously published algorithm for a maximum surgical blood order schedule (MSBOS) was applied to institutional operating rooms.

Purpose of the Study:

  • To evaluate the effectiveness of an MSBOS in reducing unnecessary preoperative blood testing.
  • To assess the associated cost savings from optimized blood ordering.

Main Methods:

  • Data from 2011-2014 surgical cases at UC Irvine Health were extracted from anesthesia information management systems (AIMS).
  • Blood order recommendations were generated using the MSBOS algorithm based on case characteristics.
  • Current ordering practices were compared to actual blood utilization, and a cost analysis was performed.

Main Results:

  • For patients categorized by MSBOS as needing no blood, 14.0% had type and screen, and 5.8% had type and crossmatch ordered.
  • For procedures where MSBOS recommended only type and screen, 38.8% had blood crossmatched.
  • The MSBOS resulted in an annual cost reduction of $57,335 compared to historical practices.

Conclusions:

  • The algorithm for developing a multispecialty blood order schedule is transferable to different institutions.
  • Implementation of the MSBOS led to significant reductions in preoperative blood product screening.