The impact of patient blood management on blood utilization and clinical outcomes in complex spine surgery

Transfusion ◽  
2019 ◽  
Vol 59 (12) ◽  
pp. 3639-3645
Author(s):  
Mereze Visagie ◽  
Caroline X. Qin ◽  
Brian C. Cho ◽  
Kevin R. Merkel ◽  
Tymoteusz J. Kajstura ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Spine Surgery ◽  
Patient Blood Management ◽  
Blood Management ◽  
Blood Utilization ◽  
The Impact

Blood utilization and clinical outcomes in pancreatic surgery before and after implementation of patient blood management

Transfusion ◽  
2020 ◽  
Vol 60 (11) ◽  
pp. 2581-2590
Author(s):  
Steven M. Frank ◽  
Brian D. Lo ◽  
Lekha V. Yesantharao ◽  
Kevin R. Merkel ◽  
Caroline X. Qin ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Pancreatic Surgery ◽  
Patient Blood Management ◽  
Blood Management ◽  
Before And After ◽  
Blood Utilization

scholarly journals Seeking Strategies to Optimize Blood Utilization: The Preliminary Experience with Implementing a Patient Blood Management Program in a Greek Tertiary Hospital

2021 ◽  
Vol 10 (10) ◽  
pp. 2141
Author(s):  
Aimilia Tsante ◽  
Anastasia Papandreadi ◽  
Andreas G. Tsantes ◽  
Elias Kyriakou ◽  
Panagiota Douramani ◽  
...  
Keyword(s):  
Tertiary Hospital ◽  
Management Program ◽  
Transfusion Practice ◽  
Patient Blood Management ◽  
Medical Patients ◽  
Blood Management ◽  
Transfusion Threshold ◽  
Restrictive Transfusion ◽  
Implementation Period ◽  
Blood Utilization

Objectives: Our aim was to assess blood utilization after implementation of a patient blood management (PBM) program in a Greek tertiary hospital. Methods: An electronic transfusion request form and a prospective audit of transfusion practice were implemented. After the one-year implementation period, a retrospective review was performed to assess transfusion practice in medical patients. Results: Pre-PBM, a total of 9478 RBC units were transfused (mean: 1.75 units per patient) compared with 9289 transfused units (mean: 1.57 units per patient) post-PBM. Regarding the post-PBM period, the mean hemoglobin (Hb) level of the 3099 medical patients without comorbidities transfused was 7.19 ± 0.79 gr/dL. Among them, 2065 (66.6%) had Hb levels >7.0 gr/dL, while 167 (5.3%) had Hb levels >8.0 gr/dL. In addition, 331 (25.3%) of the transfused patients with comorbidities had Hb >8.0 gr/dL. The Hb transfusion thresholds significantly differed across the clinics (p < 0.001), while 21.8% of all medical non-bleeding patients received more than one RBC unit transfusion. Conclusion: A poor adherence with the restrictive transfusion threshold of 7.0 gr/dL was observed. The adoption of a less strict threshold might be a temporary step to allow physicians to become familiar with the program and be informed on the safety and advantages of the restrictive transfusion strategy.

scholarly journals A SARS-CoV-2-pandémia hatása a vérkészítmény-felhasználásra a Pécsi Tudományegyetemen

2021 ◽  
Vol 162 (43) ◽  
pp. 1717-1723
Author(s):  
Sándor Pál ◽  
Barbara Réger ◽  
Tamás Kiss ◽  
Hussain Alizadeh ◽  
András Vereczkei ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Blood Cell ◽  
Red Blood Cell ◽  
Blood Product ◽  
Patient Blood Management ◽  
Blood Products ◽  
Blood Management ◽  
Number Of Patients ◽  
Willingness To Donate ◽  
The Impact

Összefoglaló. Bevezetés: A COVID–19-világjárvány betegellátásra gyakorolt hatása hazánkban is jelentős. A vérellátást nehezítette a járványügyi intézkedések következményeként a véradási események elmaradása, a csökkent véradási hajlandóság, továbbá a nehezen megítélhető vérkészítményigény . A „Patient Blood Management” irányelveinek az orvosi gyakorlatban történő egyre szélesebb körű alkalmazása elősegíti az optimális vérkészítmény-felhasználást a transzfúziók lehetőség szerinti elkerülésével. Célkitűzés és módszer: Vizsgálatunk célja a Pécsi Tudományegyetem Klinikai Központjának Janus Pannonius Klinikai Tömbjében a vérkészítmény-felhasználás változásainak felmérése volt a 2020. év első öt hónapjában. Eredmények: A járványügyi intézkedéseket követő időszakban szignifikánsan csökkent a hospitalizált betegeknek (34,08%), a transzfúziót igénylő betegeknek (39,69%) és a felhasznált vörösvérsejt-készítményeknek (46,41%) a száma, valamint az egy betegre jutó felhasznált vörösvérsejt-koncentrátum átlaga (2,61-ről 1,97-re) is. Közel 30%-os arányban csökkent a felhasznált friss fagyasztott plazma egységeinek és a thrombocytakoncentrátumoknak a száma is. Következtetés: A szigorú korlátozások életbe léptetését követően a nehézségek ellenére sikerült elegendő mennyiségű vérkészítményt biztosítani a betegeknek. Az Országos Vérellátó Szolgálat Pécsi Regionális Vérellátó Központja munkatársainak és a klinikusok erőfeszítéseinek köszönhetően a vérkészítményigény és -kínálat között új egyensúly alakult ki, mely megfelelő ellátást biztosított a feltétlenül szükséges transzfúziók kivitelezéséhez. Orv Hetil. 2021; 162(43): 1717–1723. Summary. Introduction: The impact of COVID–19 pandemic on patient care is pronounced also in Hungary. Blood supply was hindered by the reduction of public blood donation events, the reduced willingness to donate, and the difficult predictability of blood product demand as a result of the epidemiological regulations. The wider application of Patient Blood Management guidelines in the medical practice will promote optimal blood product utilization by avoiding transfusions where possible. Objective and method: The aim of our study was to assess the changes in the usage of blood products in the first five months of 2020 at the Clinical Center of the University of Pécs, Janus Pannonius Clinical Building. Results: In the period following the epidemiological measures, we found reduction in the number of hospitalized patients (34.08%), in the number of patients requiring transfusion (39.69%) and in the number of red blood cell products used (46.41%). The number of transfused red blood cell concentrates per patient was also significantly reduced (from 2.61 to 1.97) in this period. The number of transfused fresh frozen plasma units and platelet concentrates also decreased by approximately 30%. Conclusion: After the implementation of the strict restrictions, despite the difficulties, it was possible to provide patients with sufficient blood products. Due to the efforts of both the Regional Blood Transfusion Center of Pécs of the Hungarian National Blood Transfusion Service and of the clinicians, a new balance was established between the demand and the supply of blood products, which provided adequate care for the necessary transfusions. Orv Hetil. 2021; 162(43): 1717–1723.

Implementing a Health System–wide Patient Blood Management Program with a Clinical Community Approach

2017 ◽  
Vol 127 (5) ◽  
pp. 754-764 ◽  
Author(s):  
Steven M. Frank ◽  
Rajiv N. Thakkar ◽  
Stanley J. Podlasek ◽  
K. H. Ken Lee ◽  
Tyler L. Wintermeyer ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Health System ◽  
Cost Savings ◽  
Management Program ◽  
Patient Blood Management ◽  
Blood Management ◽  
Community Approach ◽  
Clinical Community ◽  
Acquisition Costs ◽  
Blood Utilization

Abstract Background Patient blood management programs are gaining popularity as quality improvement and patient safety initiatives, but methods for implementing such programs across multihospital health systems are not well understood. Having recently incorporated a patient blood management program across our health system using a clinical community approach, we describe our methods and results. Methods We formed the Johns Hopkins Health System blood management clinical community to reduce transfusion overuse across five hospitals. This physician-led, multidisciplinary, collaborative, quality-improvement team (the clinical community) worked to implement best practices for patient blood management, which we describe in detail. Changes in blood utilization and blood acquisition costs were compared for the pre– and post–patient blood management time periods. Results Across the health system, multiunit erythrocyte transfusion orders decreased from 39.7 to 20.2% (by 49%; P &lt; 0.0001). The percentage of patients transfused decreased for erythrocytes from 11.3 to 10.4%, for plasma from 2.9 to 2.2%, and for platelets from 3.1 to 2.7%, (P &lt; 0.0001 for all three). The number of units transfused per 1,000 patients decreased for erythrocytes from 455 to 365 (by 19.8%; P &lt; 0.0001), for plasma from 175 to 107 (by 38.9%; P = 0.0002), and for platelets from 167 to 141 (by 15.6%; P = 0.04). Blood acquisition cost savings were $2,120,273/yr, an approximate 400% return on investment for our patient blood management efforts. Conclusions Implementing a health system-wide patient blood management program by using a clinical community approach substantially reduced blood utilization and blood acquisition costs.

scholarly journals Blood utilization in revision versus first-time cardiac surgery: an update in the era of patient blood management

Transfusion ◽  
2017 ◽  
Vol 58 (1) ◽  
pp. 168-175 ◽  
Author(s):  
Nadia B. Hensley ◽  
Megan P. Kostibas ◽  
William W. Yang ◽  
Todd C. Crawford ◽  
Kaushik Mandal ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Patient Blood Management ◽  
Blood Management ◽  
Blood Utilization ◽  
First Time

scholarly journals Impact of ferric carboxymaltose in patient blood management in Portuguese hospitals

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
J Lucas ◽  
P Sousa ◽  
R Sequeira ◽  
C Isoppo ◽  
G Quinaz Romana ◽  
...  
Keyword(s):  
Positive Impact ◽  
Ferric Carboxymaltose ◽  
Patient Blood Management ◽  
Blood Management ◽  
Safety And Health ◽  
Minimize Blood Loss ◽  
Health Quality ◽  
Hospital Stays ◽  
Immunological Reactions ◽  
The Impact

Abstract Background The use of transfusions leads to excessive blood consumption, implying risks such as infections and immunological reactions, so it should be used only when strictly necessary. Patient Blood Management (PBM) aims to minimize the use of allogeneic blood and improve clinical outcomes, with better cost-effectiveness, using three essential points: improving hematopoiesis, minimize blood loss in and optimize the hemoglobin reserves of each patient. The aim of this work is to assess the preoperative haemoglobin optimization using ferric carboxymaltose as part of PBM implementation, in elective orthopaedic, cardiac and colorectal surgery in Portuguese hospitals. Methods This is an observational study materialized in a retrospective and multicenter cohort with data collection from medical records. The population and sample will be patients over 18 years from elective orthopaedic, cardiac and colorectal surgeries, treated according with local standards before PBM implementation were assigned to the pre-PBM cohort and patients after PBM implementation with ferric carboxymaltose to preoperative haemoglobin optimization to the PBM cohort. The criteria for selecting hospitals will be the implementation of PBM during the study period. Expected Results Based on a previous review, it is expected that the results of the use of ferric carboxymaltose to correct iron deficiency anaemia for preoperative haemoglobin optimization will contribute positively to reducing the number of transfusions, the length of hospital stays and will have a direct impact on economic results. Conclusions The use of ferric carboxymaltose and other ferric compounds, as part of PBM program, has demonstrated a positive impact on patients' outcomes (morbility and mortality), adverse events and on economic results. This study might show that clinical guidelines and programs like PBM are a major contribution not just for hemovigilance and blood safety but also for patient safety and health quality. Key messages This work is focused on Portuguese hospitals and aims to assess the impact of ferric carboxymaltose and its benefit on PBM strategy. Specially this study intends to conduct the assessment on health outcomes and costs.

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