By implementing evidence-based blood transfusion guidelines and industry-wide standards, supported by an efficiency dashboard, hospitals could save millions annually in blood purchasing costs alone, according to Premier health alliance.
A Premier analysis of 464 hospitals found that if those hospitals reduced blood product usage by 802,716 units (while still maintaining positive patient outcomes), the hospitals could save $165 million annually in blood purchasing costs alone by reducing usage.
According to Premier’s analysis of 7.4 million discharges from April 2011 to March 2012, although many clinical practice guidelines for blood product usage exist, there is not much scientific evidence supporting specific practice recommendations. A lack of strong evidence, coupled with differences in patient type and need, often leads to overuse of blood products and waste, and can cause discrepancies in how and when surgeons and anesthesiologists order blood products.
In April 2012, Premier created an efficiency dashboard that identified 15 separate categories where there could likely be savings opportunities for hospitals; waste in healthcare was one of these 15 categories. According to the dashboard analysis, blood utilization represents the eighth highest savings opportunity for hospitals.
“It’s well known that there is opportunity to reduce waste in healthcare. A missing link has been specific data to conduct comparative analysis on the effectiveness of different practices,” said Mike Alkire, chief operating officer at Premier. “Our goal in conducting this analysis is to raise awareness of the economic realities of blood use and encourage providers to think more critically about their usage patterns.”
Alkire added that the transfusion of blood products is a critical part of clinical care. In the U.S., blood is used every two to three seconds to treat patients with cancer and other serious diseases, for organ transplants and to save the lives of accident and trauma victims. “There are up to 4.5 million Americans saved each year due to transfusions, or more than 12,000 lives a day,” he said.
[See also: Premier puts analytics to work on waste]
Alkire said that while variation with blood usage is expected, there are critical factors for successful blood management:
- Utilize a multi-disciplinary blood stewardship team.
- Work collaboratively with clinicians and supply executives.
- Implement evidence-based transfusion guidelines.
- Provide education and clinical decision support tools to inform clinicians of guidelines in real time.
- Develop a process to monitor guideline adherence and provide feedback to clinicians.
- Monitor utilization regularly and measure improvement impact.