A pragmatic approach to embedding patient blood management in a tertiary hospital
BACKGROUND: We describe the implementation and impact of a patient blood management program (PBMP) in an Australian teaching hospital. STUDY DESIGN AND METHODS: A PBMP was introduced at a single tertiary care hospital in 2009 as a pilot for the Western Australian Health Department statewide PBMP. Th...
| Main Authors: | , , , , , , , , , , , , , , , , |
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| Format: | Journal Article |
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Wiley-Blackwell
2014
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| Online Access: | http://hdl.handle.net/20.500.11937/25407 |
| _version_ | 1848751699399802880 |
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| author | Leahy, M. Roberts, H. Mukhtar, Syed Aqif Farmer, Shannon Tovey, J. Jewlachow, V. Dixon, T. Lau, P. Ward, M. Vodanovich, M. Trentino, K. Kruger, P. Gallagher, T. Koay, A. Hofmann, Axel Semmens, James Towler, Simon |
| author_facet | Leahy, M. Roberts, H. Mukhtar, Syed Aqif Farmer, Shannon Tovey, J. Jewlachow, V. Dixon, T. Lau, P. Ward, M. Vodanovich, M. Trentino, K. Kruger, P. Gallagher, T. Koay, A. Hofmann, Axel Semmens, James Towler, Simon |
| author_sort | Leahy, M. |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | BACKGROUND: We describe the implementation and impact of a patient blood management program (PBMP) in an Australian teaching hospital. STUDY DESIGN AND METHODS: A PBMP was introduced at a single tertiary care hospital in 2009 as a pilot for the Western Australian Health Department statewide PBMP. The first 3 years of interventions aimed to make effective use of preoperative clinics, manage perioperative anemia, improve perioperative hemostasis, reduce blood sample volumes, and implement restrictive transfusion triggers and a single-unit transfusion policy. RESULTS: Between 2008 and 2011, admissions to Fremantle Hospital and Health Services increased by 22%.Using 2008 as a reference year, the mean number of red blood cell (RBC) units per admission declined 26%by 2011. Use of fresh-frozen plasma and platelets showed 38 and 16% declines, respectively. Cryoprecipitate increased 7% over the 4-year period. For elective admissions between 2008 and 2011, the leading decline in RBC transfusion rate was seen in cardiothoracic surgery (27.5% to 12.8%). The proportion of single RBC unit use increased from 13% to 28%(p < 0.001), and the proportion of double units decreased from 48% to 37% (p < 0.001). CONCLUSION: This is the first tertiary hospital in Australia to establish a multidisciplinary multimodal PBMP. Interventions across disciplines resulted in decreased use of RBC units especially in orthopedic and cardiothoracic surgery. Continuing education and feedback to specialties will maintain the program, improve patient outcomes, and decrease the transfusion rate. |
| first_indexed | 2025-11-14T07:56:53Z |
| format | Journal Article |
| id | curtin-20.500.11937-25407 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| last_indexed | 2025-11-14T07:56:53Z |
| publishDate | 2014 |
| publisher | Wiley-Blackwell |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-254072017-09-13T15:15:33Z A pragmatic approach to embedding patient blood management in a tertiary hospital Leahy, M. Roberts, H. Mukhtar, Syed Aqif Farmer, Shannon Tovey, J. Jewlachow, V. Dixon, T. Lau, P. Ward, M. Vodanovich, M. Trentino, K. Kruger, P. Gallagher, T. Koay, A. Hofmann, Axel Semmens, James Towler, Simon orthopedic and cardiothoracic surgery plasma anemia teaching hospital platelets patient blood management program (PBMP) transfusion BACKGROUND: We describe the implementation and impact of a patient blood management program (PBMP) in an Australian teaching hospital. STUDY DESIGN AND METHODS: A PBMP was introduced at a single tertiary care hospital in 2009 as a pilot for the Western Australian Health Department statewide PBMP. The first 3 years of interventions aimed to make effective use of preoperative clinics, manage perioperative anemia, improve perioperative hemostasis, reduce blood sample volumes, and implement restrictive transfusion triggers and a single-unit transfusion policy. RESULTS: Between 2008 and 2011, admissions to Fremantle Hospital and Health Services increased by 22%.Using 2008 as a reference year, the mean number of red blood cell (RBC) units per admission declined 26%by 2011. Use of fresh-frozen plasma and platelets showed 38 and 16% declines, respectively. Cryoprecipitate increased 7% over the 4-year period. For elective admissions between 2008 and 2011, the leading decline in RBC transfusion rate was seen in cardiothoracic surgery (27.5% to 12.8%). The proportion of single RBC unit use increased from 13% to 28%(p < 0.001), and the proportion of double units decreased from 48% to 37% (p < 0.001). CONCLUSION: This is the first tertiary hospital in Australia to establish a multidisciplinary multimodal PBMP. Interventions across disciplines resulted in decreased use of RBC units especially in orthopedic and cardiothoracic surgery. Continuing education and feedback to specialties will maintain the program, improve patient outcomes, and decrease the transfusion rate. 2014 Journal Article http://hdl.handle.net/20.500.11937/25407 10.1111/trf.12362 Wiley-Blackwell restricted |
| spellingShingle | orthopedic and cardiothoracic surgery plasma anemia teaching hospital platelets patient blood management program (PBMP) transfusion Leahy, M. Roberts, H. Mukhtar, Syed Aqif Farmer, Shannon Tovey, J. Jewlachow, V. Dixon, T. Lau, P. Ward, M. Vodanovich, M. Trentino, K. Kruger, P. Gallagher, T. Koay, A. Hofmann, Axel Semmens, James Towler, Simon A pragmatic approach to embedding patient blood management in a tertiary hospital |
| title | A pragmatic approach to embedding patient blood management in a tertiary hospital |
| title_full | A pragmatic approach to embedding patient blood management in a tertiary hospital |
| title_fullStr | A pragmatic approach to embedding patient blood management in a tertiary hospital |
| title_full_unstemmed | A pragmatic approach to embedding patient blood management in a tertiary hospital |
| title_short | A pragmatic approach to embedding patient blood management in a tertiary hospital |
| title_sort | pragmatic approach to embedding patient blood management in a tertiary hospital |
| topic | orthopedic and cardiothoracic surgery plasma anemia teaching hospital platelets patient blood management program (PBMP) transfusion |
| url | http://hdl.handle.net/20.500.11937/25407 |