A team of administrative and executive leaders, nurses, physicians and house staff at VUMC created a set of guidelines for blood utilization practices that produced $2 million in savings and a 30 percent decrease in blood utilizationsince 2011.
When more than one unit of blood is ordered at the hospital, it comes in a cooler — reconfigured to improve temperature management — instead of a pneumatic tube. One staff member is given “ownership” of the blood products and is responsible for giving any unused units back to the blood bank. Individual unit waste is also reported to clinical leaders for review.
These new guidelines decreased the number of blood units wasted from 300 in 2011 to fewer than 80 in 2015.
The team also updated VUMC’s blood ordering practices to revolve around a close assessment of individual patient cases. Previously, the standard practice was to order two units of blood every time a patient needed blood. Now, the hospital’s computerized provider order entry system is set to order one unit of blood, and physicians are encouraged to asses whether patients actually need a second unit before ordering.
This system allowed the hospital to reduce its red blood cell transfusions from 675 units per 1,000 discharges in 2011 to 432 units per 1,000 discharges in 2015.
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