ATLANTA—Implementing a blood management program across a health system optimizes blood utilization in cardiac surgery and saves blood acquisition costs, according to a poster presentation featured during the American College of Cardiology Administrators (ACCA) annual cardiovascular administrators leadership conference this week.
Cardiac surgery patients utilize approximately 20 percent of all blood products in the U.S. However, according to Margaret Simor, RN, from John Muir Health (JMH) in Concord, Calif., and her colleagues, due to the “increasing blood costs and growing evidence of the deleterious effects of transfusion in cardiac surgery patients, hospitals are seeking ways to minimize the use of this scarce, expensive and hazardous resource.”
Members of JMH’s Cardiovascular Performance Improvement (CVPI) Committee attempted to develop a program to optimize blood utilization in cardiac surgery. Despite “some marginal improvements,” the infrastructure to create sustainable, long-term change does not exist, according to the researchers. Due to widespread “antiquated beliefs” among the clinical staff related to blood component therapy, they wrote that a major clinical shift is needed to modify current blood ordering and administration practices.
Strategic Healthcare Group, a blood management solutions company, performed an evaluation of the JMH organization, identifying high-yield opportunities from a safety, quality and economic perspective across both campuses. Through a change management process, clinical opinion leaders and administrators were educated and engaged to be program champions.
As a result, JMH launched a cross-campus blood management team to provide oversight for blood utilization and transfusion safety. The team includes representation from cardiovascular surgery and anesthesia and is chaired by a physician who provides peer to peer education. The CVPI committee also oversaw the implementation of the consultant recommendations in cardiac surgery.
As a result of the changes implemented in 2006, Simor and colleagues reported a 47 percent reduction in blood product use was achieved in cardiac surgery (blood product use was reduced to 4.5 products per case), and overall costs were reduced by $681 per case.
Despite a 27 percent increase in cardiac surgery and an increase in blood supplier costs between 2007-2009, the researchers said that the program saved $541,110 in blood acquisition costs for cardiac surgery alone, and nearly $1.9 million between the two campuses.