Case Study: Level One Trauma Center

Introduction:  Transfusion  of  blood  products  is  associated  with  pulmonary,  renal,  cardiac,  and  neurologic  complications  and  death.  We  previously  and  recently  described  objective  laboratory  guided  transfusion  algorithms  for  transfusing  blood  components  (platelets,  fresh  frozen  plasma,  and  cryoprecipitate)  for  excessive  bleeding  in  the  operating  room  and  intensive  care  unit  for  cardiac  surgery  patients.    

Methodology:  Soon  after  establishing  buy-­‐in  from  clinical  leaders,  education  efforts  began  the  first  month  of  the  engagement.  Physicians  and  nurses  were  separately  introduced  to  PBM  concepts  at  department  and  section  meetings.  As  a  result  of  a  heightened  awareness  about  transfusions,  noticeable  decreases  in  utilization  were  observed  in  the  first  month.  

In-­‐depth  education  sessions  were  provided  to  nursing  staffing  covering  identification  and  treatment  of  transfusion  reactions  and  patient  identification.  A  transfusion  incident  reporting  SOP  was  established  in  collaboration  with  hospital  quality  personnel  and  implemented  to  track  delayed  and  mis-­‐transfusions.  

 

Transfuse Solutions, Inc.

info@transfusesolutions.com

“Their phased approach with

education, transfusion committee

participation, and data analytics will lead to continued

improvement in clinical outcomes and safety for our

patients, as well as financial benefits to our institution.”

-Chief Operating Officer

Case Study: Level One Trauma Center

“Transfuse Solutions’

scientifically sound and

clinically innovative

program has led to heightened

awareness of the need to drive

optimal transfusion practices”

-Chief Medical Officer

   

As  part  of  the  change  management  plan  a  Transfusion  Committee  was  established  which  approved  Transfusion  Guidelines  suggested  by  the  AABB.  The  guidelines  were  later  approved  as  hospital  policy  and  have  served  as  an  authority  when  confronting  inappropriate  transfusions.  

 

 

Results:  Aggressive  educational  and  change  management  efforts  have  lead  to  an  8.4%  reduction  in  utilization  and  $200,000  in  direct  savings  during  Q1  of  a  PBM  2.0  ProgramTM.  Much  of  the  savings  are  attributed  to  clinician  education  and  newly  establish  transfusion  policies.  Such  a  significant  decrease  in  utilization  is  impressive  considering  that  technology  components  of  the  program  were  not  scheduled  for  deployment  until  Q3.  After  implementing  online  credentialing  modules  and  clinical  decision  support  tools,  it  is  anticipated  that  the  hospital  will  achieve  at  least  a  30%  total  net  reduction  in  utilization  by  the  end  of  the  second  program  year.  

  Utilization  is  tracked  on  a  monthly  basis  and  compared  to  a  baseline  metric  calculated  from  a  16-­‐month  average.  Although  utilization  increased  slightly  during  the  second  month,  the  significant  drop  in  utilization  in  January  and  March  confirm  the  savings  realized.  $200,000  in  savings  was  achieved  in  this  first  quarter  and  we  anticipate  further  savings  after  implementing  our  Transformational  Change  Portal  which  include  clinician  credentialing  modules  for  ordering  and  administering  blood,  as  well  as  clinical  decision  support  tools.  Furthermore,  Computerize  Physician  Order  Sets  (CPOE)  will  be  implemented  in  Q1  of  the  following  year,  requiring  the  Transfusion  policy.  We  look  forward  to  continue  delivering  improved  patient  safety  and  financial  savings  with  our  Patient  Blood  Management  2.0TM  program.  

Hospital Characteristics

3rd largest trauma ctr in US

390 beds

$4MM Blood spend

Burn Center

Trauma Center

High Risk Obstetrics

Neonatal ICU

4,500 annual trauma admissions