- By adjusting practices around blood utilization, transportation, and storage, hospitals have the potential to save millions of dollars, reduce blood wastage, and improve patient care, according to a research team from Vanderbilt University Medical Center in Nashville, Tenn.
- The team's development of blood utilization guidelines resulted in a savings at Vanderbilt of $2 million and a 30% reduction in blood utilization.
- Additional guidelines addressed inefficiencies in blood ordering, transport, and storage.
The team posited that the blood utilization guidelines are also good for patients because previous research shows restrictive transfusion policies results in better patient outcomes due to transfusions' association with complications including reaction, infection, volume overload, increased length of stay, and mortality.
In 2015, the U.S. News & World Report found the excessive amount of blood transfusions in the country is one of the most common medical errors. The BMJ reported in May medical errors, accounting for 251,000 U.S. deaths annually, are the third leading cause of death after cancer and heart disease.
Such monetary savings could put one more dent in rising healthcare costs, and such blood savings could prove particularly valuable in the instance of any shortage--as well as in assuring donors their contributions are being used responsibly.
The guidelines could easily be implemented at other health systems, though it requires changing the mindset of the institution, the study authors said.
Their first step was to change standard practice via their Computerized Provider Order Entry (CPOE) from ordering two units of blood at a time to ordering a single unit and then having providers order any more blood as indicated by a case assessment.
"By revising CPOE, Vanderbilt was able to reduce red blood cell transfusions by more than 30%--from 675 units per 1,000 discharges in 2011 down to 432 units per 1,000 discharges in 2015," the researchers reported.
The guidelines aimed at improving efficiency include sending blood in a cooler rather than a pneumatic tube for orders of more than one unit; reconfiguring coolers to optimize temperatures; assigning a staff member "ownership" of the blood products and the return of unused products to the blood bank; and the reporting of wastage for review.
Vanderbilt was able to reduce its wastage from 300 units in 2011 to less than 80 units in 2015.