Improving the Appropriateness of Red Blood Cell Transfusions in Patients Undergoing Orthopedic Surgery

Author:

Audet Anne-Marie1,Andrzejewski Chester2,Popovsky Mark3

Affiliation:

1. Massachusetts Peer Review Organization

2. Baystate Medical Center

3. American Red Cross, Harvard Medical School

Abstract

Othopedic surgery is a common procedure among the elderly, and patients are at risk of receiving unnecessaryblood transfusions. The goals of this project were to analyze current transfusion practices, identify opportunities for improvement, implement hospital-based quality improvement programs, and measure their impact on transfusion practices. Our aims were to decrease unnecessary transfusions and overall exposure to blood products. Data were abstractedfrom medical records, at baseline and postintervention. The results demonstrated significant improvements: a 55% decrease in avoidable transfusion events (from 42% to 19%o, p < .001) and a decrease in the pre-transfusion hematocritfrom a baseline of 29% to 26.9% in the postintervention period (p <.01). The percentage of single unit transfusion events increased from 71.9% to 77.2% (p = .05). These results suggest that the interventions had a significant impact on the use of blood. In the long term, these results should translate into cost savings and improved patient outcomes.

Publisher

SAGE Publications

Subject

Health Policy

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