5 steps to reduce blood costs at your hospital

Carle Foundation Hospital in Urbana, Ill., decreased blood transfusions by 35 percent in two years and achieved $2 million in savings by instituting a provider-led initiative to cut blood costs.

Premier conducted a nationwide analysis of inpatient data from 645 hospitals, including Carle Foundation Hospital, and found a 20 percent decrease in total blood use from 2011 to 2016. The Charlotte, N.C.-based group purchasing organization attributed the decrease to hospitals' efforts to implement evidence-based practices around blood use.

Bruce Wellman, MD, Carle Foundation's medical director of transfusion service, coagulation and laboratory information systems, shared how the hospital streamlined its blood transfusion guidelines to lower costs during a Thursday phone briefing on Premier's blood use report.

Here are five steps Dr. Wellman identified to reduce blood use and cut costs.

  1. Analyze utilization data and identify improvement areas. The hospital first assessed its blood utilization data to identify areas with the highest potential for improvement. The data showed surgery, care for chronic conditions and oncology had the highest blood utilization rates.

  1. Create an internal blood database. Carle Foundation leaders informed these departments of their opportunity to improve transfusion practices and worked directly with them to create an internal database to track and attribute every blood transfusion.

  1. Share blood utilization best practices. The hospital's best practice community launched various initiatives to lower blood use and shared evidence-based transfusion best practices with these high-use groups.

  1. Tighten up blood orders. The hospital also implemented thorough reviews of blood component orders to eliminate waste.

  1. Finalize new evidence guidelines and expand to other clinical areas. Dr. Wellman said the hospital saw improvements in blood use practices within a year. After two years, the hospital recorded an estimated 3,000 fewer transfusions with improved patient safety and reduced nursing times, lab events and testing. After the two-year pilot phase, Carle Foundation Hospital is now finalizing blood transfusion best practices to expand to other clinical areas.

    "The next step will be to try to reach out more broadly and make sure our nurses and advanced practice providers understand the guidelines and provide feedback for more appropriate use," Dr. Wellman said during the call.To view Premier's full blood utilization report, click here.

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