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2014 ; 121
(3
): 501-9
Nephropedia Template TP
gab.com Text
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English Wikipedia
Reducing unnecessary preoperative blood orders and costs by implementing an
updated institution-specific maximum surgical blood order schedule and a remote
electronic blood release system
#MMPMID24932853
Frank SM
; Oleyar MJ
; Ness PM
; Tobian AA
Anesthesiology
2014[Sep]; 121
(3
): 501-9
PMID24932853
show ga
BACKGROUND: Using blood utilization data acquired from the anesthesia information
management system, an updated institution-specific maximum surgical blood order
schedule was introduced. The authors evaluated whether the maximum surgical blood
order schedule, along with a remote electronic blood release system, reduced
unnecessary preoperative blood orders and costs. METHODS: At a large academic
medical center, data for preoperative blood orders were analyzed for 63,916
surgical patients over a 34-month period. The new maximum surgical blood order
schedule and the electronic blood release system (Hemosafe; Haemonetics Corp.,
Braintree, MA) were introduced mid-way through this time period. The authors
assessed whether these interventions led to reductions in unnecessary
preoperative orders and associated costs. RESULTS: Among patients having surgical
procedures deemed not to require a type and screen or crossmatch (n = 33,216),
the percent of procedures with preoperative blood orders decreased by 38% (from
40.4% [7,167 of 17,740 patients] to 25.0% [3,869 of 15,476 patients], P < 0.001).
Among all hospitalized inpatients, the crossmatch-to-transfusion ratio decreased
by 27% (from 2.11 to 1.54; P < 0.001) over the same time period. The proportion
of patients who required emergency release uncrossmatched blood increased from
2.2 to 3.1 per 1,000 patients (P = 0.03); however, most of these patients were
having emergency surgery. Based on the realized reductions in blood orders,
annual costs were reduced by $137,223 ($6.08 per patient) for surgical patients,
and by $298,966 ($6.20/patient) for all hospitalized patients. CONCLUSION:
Implementing institution-specific, updated maximum surgical blood order
schedule-directed preoperative blood ordering guidelines along with an electronic
blood release system results in a substantial reduction in unnecessary orders and
costs, with a clinically insignificant increase in requirement for emergency
release blood transfusions.
|*Blood Banks
[MESH]
|*Blood Grouping and Crossmatching/instrumentation
[MESH]