Reducing preoperative blood orders and costs for radical prostatectomy

Area of Science:

• Urology
• Transfusion Medicine
• Healthcare Management

Background:

• Radical prostatectomy (RP) is a common urologic procedure associated with potential blood loss.
• Preoperative blood ordering practices can lead to unnecessary blood preparation and associated costs.
• Optimizing blood ordering is crucial for efficient healthcare resource management.

Purpose of the Study:

• To evaluate the impact of implementing a maximum surgical blood order schedule (MSBOS) on preoperative blood ordering for radical prostatectomy (RP).
• To assess changes in blood ordering practices before and after MSBOS implementation.
• To determine the cost-effectiveness of MSBOS in reducing unnecessary blood preparation.

Main Methods:

• Retrospective review of patients undergoing RP between 2010 and 2016.
• Categorization of patients based on the implementation date of the MSBOS (pre- or post-implementation).
• Comparison of preoperative blood ordering practices (e.g., type and cross-match, type and screen, no sample) between the two groups.

Main Results:

• Following MSBOS implementation, preoperative blood orders for robot-assisted laparoscopic RP shifted from predominantly type and cross-match 2 units (53%) to no sample (56%).
• For open RP, orders changed from mostly type and cross-match 2 units (62%) to type and screen (75%).
• These changes resulted in significant cost savings due to reduced unnecessary blood preparation.

Conclusions:

• MSBOS implementation effectively decreases unnecessary preoperative blood orders for radical prostatectomy.
• Compliance with MSBOS guidelines optimizes blood utilization and resource allocation.
• The study demonstrates the value of standardized blood ordering schedules in surgical settings.