Seeking Strategies to Optimize Blood Utilization: The Preliminary Experience with Implementing a Patient Blood...

Area of Science:

• Transfusion Medicine
• Healthcare Management
• Clinical Practice Improvement

Background:

• Patient blood management (PBM) programs aim to optimize red blood cell (RBC) utilization.
• Implementing PBM requires changes in transfusion practices and physician adherence.
• Assessing PBM effectiveness is crucial for improving patient outcomes and resource allocation.

Purpose of the Study:

• To evaluate blood utilization following the implementation of a PBM program in a Greek tertiary hospital.
• To analyze transfusion practices and adherence to transfusion thresholds in medical patients post-PBM implementation.

Main Methods:

• Introduction of an electronic transfusion request form and a prospective audit of transfusion practices.
• Retrospective review of transfusion data for medical patients one year after PBM program implementation.
• Analysis of red blood cell (RBC) units transfused and hemoglobin (Hb) levels in relation to transfusion thresholds.

Main Results:

• A marginal reduction in RBC units transfused per patient was observed post-PBM (1.57 vs. 1.75 units).
• A significant proportion of patients (66.6%) had Hb levels >7.0 g/dL at transfusion, indicating poor adherence to the restrictive threshold.
• Transfusion thresholds varied significantly across clinical departments, with 21.8% of non-bleeding medical patients receiving more than one RBC unit.

Conclusions:

• Adherence to the restrictive transfusion threshold of 7.0 g/dL was poor after PBM implementation.
• A less strict initial threshold may be a transitional strategy to familiarize physicians with PBM.
• Further education and reinforcement are necessary to promote the adoption of restrictive transfusion strategies and maximize PBM benefits.