Transfusion medicine

Blood transfusions reduced with better pre-op care

A two-year project to optimise haemoglobin and iron stores in patients prior to elective surgery has been successful in decreasing the number of patients receiving blood transfusions and the number of units of blood transfused.

The National Patient Blood Management Collaborative, which ran across 12 health services in seven states and territories, was able to increase the proportion of patients receiving a pre-operative haemoglobin check from 73% to 99%.

Assessment rates for iron deficiency more than doubled – from 25% to 57% in gastrointestinal patients, 35% to 71% in orthopedic patients and 18% to 42% in gynaecology patients.

The project, led by the Australian Commission on Safety and Quality in Heath Care, also resulted in a marked improvement in the pre-operative management of iron deficiency (from 40% to 60%).

Associate Professor Lilon Bandler, chair of the Commission’s Patient Blood Management Project Reference Group, told the limbic the project represented an ‘intensive effort in quality improvement’.

“I really congratulate those hospitals who quarantined people and resources for this project. Change is often instructed from atop leading to a loss in translation. But if you can get the resources right, the channels of communication and the people right, then you can deliver change.”

She said engagement from clinical champions and senior executives alike provided the reassurance that the project was important and encouraged a change in practice.

“Blood is donated and is a precious gift so it is our duty to donors to use it appropriately, thoughtfully and carefully. It is also about ensuring good clinical care.”

Associate Professor Bandler, a GP, said having an identifiable point of contact within hospitals was particularly helpful to manage the transfer of patients from primary care and back again.

“I can check haemoglobin and iron levels in general practice but communicating those results to the people who will care for patients in hospital is very important.”

While the project was now completed, she said ‘its time had come’ and other organisations including the National Blood Authority would continue the work.

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