Transfusion Utilization and Appropriateness: Thinking Differently at a Tertiary Academic Medical Center

Jennifer Dawson, MBA, MSN, RN, NE-BC; Craig Schwabl, BS, MBA; Peter Pronovost, MD, PhD; Richard Jordan, MD, MS; Keith A. Andrews, DO; Zil Patel, DO; James Hill, Jr., MD, MBA, CPE, FASA, FACHE

July 8, 2022
Physician Leadership Journal
Volume 9, Number 4, Pages 18-23


Optimizing the transfusion of blood components reduces risk to patients and costs to organizations. Given the frequency of transfusion and the variation in practice, clinicians desire a way to measure performance in transfusion practices that is relevant for all patient scenarios and accurately attributes to the provider influencing the decision. To identify defects in value, an algorithm was developed that allowed rapid analysis of transfusion events to measure performance against a group of clinical measures focusing on mindful variation. Data from the blood bank inventory and electronic patient record were aggregated into an interactive dashboard and shared transparently with transfusing providers and leaders monthly to enhance awareness. It was hypothesized that an application to raise awareness to unwarranted variation would lead to a decrease in transfusions and an increase in appropriate transfusion.

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