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| [PMID]: | 28885446 |
| [Au] Autor: | Frank SM; Thakkar RN; Podlasek SJ; Ken Lee KH; Wintermeyer TL; Yang WW; Liu J; Rotello LC; Fleury TA; Wachter PA; Ishii LE; Demski R; Pronovost PJ; Ness PM |
| [Ad] Endereço: | From the Department of Anesthesiology and Critical Care Medicine (S.M.F., W.W.Y., P.J.P.), Department of Medicine (R.N.T., L.C.R.), Department of Pathology, Transfusion Medicine (S.J.P., J.L., T.A.F., P.M.N.), Armstrong Institute for Patient Safety and Quality (K.H.K.L., T.L.W., P.A.W., R.D., P.J.P.), and Department of Otolaryngology Head and Neck Surgery (L.E.I.), The Johns Hopkins Medical Institutions, Baltimore, Maryland. |
| [Ti] Título: | Implementing a Health System-wide Patient Blood Management Program with a Clinical Community Approach. |
| [So] Source: | Anesthesiology;127(5):754-764, 2017 Nov. | | [Is] ISSN: | 1528-1175 |
| [Cp] País de publicação: | United States |
| [La] Idioma: | eng |
| [Ab] Resumo: | BACKGROUND: Patient blood management programs are gaining popularity as quality improvement and patient safety initiatives, but methods for implementing such programs across multihospital health systems are not well understood. Having recently incorporated a patient blood management program across our health system using a clinical community approach, we describe our methods and results. METHODS: We formed the Johns Hopkins Health System blood management clinical community to reduce transfusion overuse across five hospitals. This physician-led, multidisciplinary, collaborative, quality-improvement team (the clinical community) worked to implement best practices for patient blood management, which we describe in detail. Changes in blood utilization and blood acquisition costs were compared for the pre- and post-patient blood management time periods. RESULTS: Across the health system, multiunit erythrocyte transfusion orders decreased from 39.7 to 20.2% (by 49%; P < 0.0001). The percentage of patients transfused decreased for erythrocytes from 11.3 to 10.4%, for plasma from 2.9 to 2.2%, and for platelets from 3.1 to 2.7%, (P < 0.0001 for all three). The number of units transfused per 1,000 patients decreased for erythrocytes from 455 to 365 (by 19.8%; P < 0.0001), for plasma from 175 to 107 (by 38.9%; P = 0.0002), and for platelets from 167 to 141 (by 15.6%; P = 0.04). Blood acquisition cost savings were $2,120,273/yr, an approximate 400% return on investment for our patient blood management efforts. CONCLUSIONS: Implementing a health system-wide patient blood management program by using a clinical community approach substantially reduced blood utilization and blood acquisition costs. |
| [Mh] Termos MeSH primário: |
Bancos de Sangue/normas
Transfusão de Sangue/normas
Serviços de Saúde Comunitária/normas
Assistência à Saúde/normas
Hospitais/normas
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| [Mh] Termos MeSH secundário: |
Bancos de Sangue/métodos
Transfusão de Sangue/métodos
Tomada de Decisão Clínica/métodos
Serviços de Saúde Comunitária/métodos
Assistência à Saúde/métodos
Seres Humanos
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| [Pt] Tipo de publicação: | JOURNAL ARTICLE |
| [Em] Mês de entrada: | 1710 |
| [Cu] Atualização por classe: | 171026 |
[Lr] Data última revisão:
| 171026 |
| [Sb] Subgrupo de revista: | AIM; IM |
| [Da] Data de entrada para processamento: | 170909 |
| [St] Status: | MEDLINE |
| [do] DOI: | 10.1097/ALN.0000000000001851 |
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