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Impact of Patient Blood Management on Red Blood Cell Utilization in an Urban Community Teaching Hospital: A
Ding Wen Wu1,2, Mark T Friedman3, Daniel P Lombardi4
1Department of Pathology, SBH Health System, Bronx, NY 10457, USA.
Insights
Implementing a patient blood management (PBM) program significantly reduced red blood cell (RBC) transfusions and costs. This PBM initiative demonstrated effective transfusion practice improvements without requiring extensive resources.
Area of Science:
- Transfusion Medicine
- Healthcare Management
- Patient Safety
Background:
- Unnecessary red blood cell (RBC) transfusions contribute to increased healthcare costs and potential patient harm.
- Effective patient blood management (PBM) programs are crucial for optimizing transfusion practices.
Purpose of the Study:
- To evaluate the impact of a PBM program on RBC transfusion rates and practices.
- To demonstrate the cost-effectiveness of PBM implementation in an urban teaching hospital.
Main Methods:
- A retrospective review of RBC transfusion data was conducted over seven years (2013-2019).
- Analysis focused on pretransfusion hemoglobin levels, RBC unit utilization, and transfusion orders.
Main Results:
- A 34% reduction in yearly RBC unit transfusions was observed post-PBM implementation.
- Mean pretransfusion hemoglobin levels decreased from 7.26 g/dL to 6.58 g/dL.
- Estimated cost savings of USD 2.1 million were achieved over six years.
Conclusions:
- PBM implementation significantly reduced RBC transfusions and improved transfusion practices.
- Successful PBM strategies can be achieved through intuitive methods, not necessarily requiring extensive resources or budgets.
Objectives:
This study aimed to showcase how implementing a patient blood management (PBM) program effectively cuts unnecessary red blood cell (RBC) transfusions in a New York City urban community teaching hospital.
Methods:
Analyzing seven years from 2013 to 2019, a retrospective review of RBC transfusions was conducted.
Results:
Following the introduction of PBM, considerable improvements were observed annually. These included a drop in mean pretransfusion hemoglobin levels from 7.26 g/dL (2013) to 6.58 g/dL (2019), a 34% reduction in yearly RBC unit transfusions, and fewer units given to patients with pre-Hgb levels ≥ 7 g/dL (from 1210 units in 2013 to 310 units in 2019). Furthermore, this study noted a decline in two-unit RBC orders when Hgb levels were ≥ 7 g/dL from 65 orders in 2013 to merely 3 in 2019. The estimated total cost savings attributed to the six-year PBM program duration after full implementation in 2014 amounted to USD 2.1 million.
Conclusions:
Overall, PBM implementation significantly decreased RBC transfusions and enhanced transfusion practices. The findings emphasize that successful PBM strategies do not always necessitate extensive resources or increased budgets but instead rely on the application of intuitive methods, as evidenced by this study.
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