Patient Blood Management (PBM) is a standard of care that departs from product focused transfusion in favour of patient focused, evidence based practice. An overwhelming body of evidence exists in the literature showing that transfusion is associated with poorer patient outcomes, adverse events, and increased costs. In 2013, the Joint Commission and the American Medical Association released a report identifying red blood cell (RBC) transfusion as one of five overused treatments. Studies have shown up to 60% of transfusions may be inappropriate.
One study found transfusion increased average length of stay by 2.5 days, had an increased odds ratio of death of 1.7 and an increased odds ratio of infection of 1.9. Hospital charges were over $17000 USD higher. An Australian study estimated the increased hospital cost of RBC transfusion to be $77 million in one year across a five hospital health service, which suggests a large financial incentive for reducing unnecessary transfusions.
Standard 7 of the Australian National Safety and Quality Health Service Standards requires that hospitals have systems in place to ensure safe and appropriate prescribing and use of blood and blood products, and that they are consistent with national evidence-based guidelines.
A Good Data System is Essential
As a standard of care, the principles of Patient Blood Management must become part of standard practice. Embedding PBM into an institution involves extensive change management – and this is heavily dependent upon having timely and accurate data. How can you change practice if you don’t know what your practices are? It is essential to target variation in care, assess compliance with national guidelines, and measure the impact of your initiatives (a key stage of the six sigma process).
We can assess your reporting and provide assistance with enhancing your capabilities. We can even develop a complete Patient Blood Management reporting framework, linking laboratory and transfusion data with patient outcomes data. We can also help with research and study design, and all aspects of implementing a PBM program in your hospital – not just data.
Please contact us to find out how we can help you today.
For more information on PBM, please see the National Blood Authority website.