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Routine Screening Method for Microparticles in Platelet Transfusions
Published on: January 31, 2018
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A randomized study of a best practice alert for platelet transfusions
Colin Murphy1, Eric Mou2, Emily Pang3
1Division of Transfusion Medicine, Department of Pathology, Stanford University School of Medicine, Stanford, California, USA.
Vox Sanguinis
|June 3, 2021
Summary
A best practice alert (BPA) for platelet transfusions reduced overall usage by 25.3% and may save over $150,000 annually. This clinical decision support tool shows promise for improving patient care and reducing costs.
Area of Science:
- Healthcare Management
- Clinical Informatics
- Transfusion Medicine
Background:
- Inappropriate platelet transfusions are a significant area for improvement in patient care.
- Clinical decision support (CDS) tools, like best practice alerts (BPAs), have proven effective in reducing unnecessary red blood cell transfusions.
Purpose of the Study:
- To evaluate the impact of a BPA for platelet transfusions using chart-based randomization.
- To assess the effect of alert visibility on platelet transfusion practices.
Main Methods:
- A BPA was developed and integrated into the electronic health record for platelet ordering.
- Alert visibility was randomized at the patient encounter level.
- Data on BPA-eligible platelet transfusions and override reasons were collected; provider interviews were conducted.
Main Results:
- The visible alert group demonstrated a 25.3% reduction in BPA-eligible platelet usage.
- Mean monthly usage of eligible platelets was lower in the visible alert group (49.1 vs. 65.7).
- No significant difference in BPA-eligible platelets used per inpatient day at risk was observed between groups.
Conclusions:
- Implementing a platelet transfusion BPA is feasible using chart-based randomization.
- The BPA reduced overall platelet utilization and indicated potential annual savings of $151,069.
- Provider feedback provided valuable insights for future CDS improvements in platelet transfusion management.
