A pragmatic approach to embedding patient blood management in a tertiary hospital
MetadataShow full item record
BACKGROUND: We describe the implementation and impact of a patient blood management program (PBMP) in an Australian teaching hospital. STUDY DESIGN AND METHODS: A PBMP was introduced at a single tertiary care hospital in 2009 as a pilot for the Western Australian Health Department statewide PBMP. The first 3 years of interventions aimed to make effective use of preoperative clinics, manage perioperative anemia, improve perioperative hemostasis, reduce blood sample volumes, and implement restrictive transfusion triggers and a single-unit transfusion policy. RESULTS: Between 2008 and 2011, admissions to Fremantle Hospital and Health Services increased by 22%.Using 2008 as a reference year, the mean number of red blood cell (RBC) units per admission declined 26%by 2011. Use of fresh-frozen plasma and platelets showed 38 and 16% declines, respectively. Cryoprecipitate increased 7% over the 4-year period. For elective admissions between 2008 and 2011, the leading decline in RBC transfusion rate was seen in cardiothoracic surgery (27.5% to 12.8%). The proportion of single RBC unit use increased from 13% to 28%(p < 0.001), and the proportion of double units decreased from 48% to 37% (p < 0.001). CONCLUSION: This is the first tertiary hospital in Australia to establish a multidisciplinary multimodal PBMP. Interventions across disciplines resulted in decreased use of RBC units especially in orthopedic and cardiothoracic surgery. Continuing education and feedback to specialties will maintain the program, improve patient outcomes, and decrease the transfusion rate.
Showing items related by title, author, creator and subject.
Effectiveness of a patient blood management data system in monitoring blood use in Western AustraliaMukhtar, Syed Aqif; Leahy, M.; Trentino, K.; Koay, A.; Semmens, James; Tovey, J.; Jewlachow, V.; Farmer, Shannon; Hofmann, A.; Roberts, H.; Towler, S. (2013)The aim of this paper is to describe a linked patient blood management (PBM) data system and to demonstrate its usefulness by presenting the blood usage data obtained. Our existing datasets already collected much of the ...
Trentino, K.; Farmer, Shannon; Swain, S.; Burrows, S.; Hofmann, Axel; Ienco, R.; Pavey, W.; Daly, F.; Van Niekerk, A.; Webb, S.; Towler, Simon; Leahy, M. (2015)Background - Red blood cell (RBC) transfusion is independently associated in a dose-dependent manner with increased intensive care unit stay, total hospital length of stay, and hospital-acquired complications. Since little ...
Hofmann, Axel; Farmer, Shannon; Towler, Simon (2012)Purpose of review: Evidence-based patient blood management (PBM) is aimed at achieving better patient outcomes by relying on a patient's own blood rather than on donor blood. This review covers the rationale behind PBM, ...