Improving Patient Blood Management
26-27 June 2017 - Sydney
Meeting Code HRT1725
The Problem: International consensus:
10% of blood transfusions are appropriate
30% have uncertain benefits
Large variation in transfusion practice among Roundtable members.
The Opportunity: Patient Blood Management is an important safety and quality initiative with the potential to improve patient outcomes whilst also reducing hospital expenditure.
- Red Blood Cell (RBC) transfusion is independently associated with increased morbidity, mortality, hospital and ICU length of stay, and increased cost.
- On average, RBC transfused patients stay 2.5 days longer, with increased odds ratio of death of 1.7.
- A recent West Australian study estimated the total hospital- associated cost of RBC transfusion across a five hospital health service to be $77 million per year.
- Blood product costs will be devolved to public hospitals and incorporated into the ABF framework.
- Existing wide variation: RBC transfusion rates vary from 8% to 93% in cardiac surgery, and 9-92% in orthopaedics. A large number of transfusions may be inappropriate and avoidable.
- Australian NSQHS Standard 7 requires that hospitals have systems in place to ensure safe and appropriate prescribing and use of blood and blood products, and that they are consistent with national evidence-based guidelines.
The Solution: Can we afford NOT to do Patient Blood Management? Western Australia is a world exemplar in PBM, we can all implement workable solutions based on the WA strategies and experience.
The problem: Western Australia Metro Data on Transfusion and Cost Retrospective cohort study from a five hospital health service in Western Australia between (July 2011 - June 2012).
After adjusting for age, gender, admit type (emergency or elective), DRG and patient complexity (HRT complexity), compared with non-transfused:
- Mean inpatient cost 1.83 Times higher in txed group.
- Estimated total hospital associated cost of RBC transfusion AUD $77 million, representing 7.8% of total hospital expenditure on acute-care inpatients.
- Significant dose-dependent association between the number of RBC units transfused and increased costs after adjusting for confounders.
Who should participate?
- This Roundtable is intended to share "good practice" ideas and innovations for PBM programs.
- Ideally, a cross- disciplinary team of those who are responsible for PBM.
- You may bring up to five people per health service.
What does The Health Roundtable do?
- Work with experts to identify key trends and innovations.
- Survey participating health services for innovative practices.
- Merge your pathology and Casemix data to benchmark blood utilisation.
- Collate and analyse results.
- Summarise the meeting and circulate all presentations.