Relative impact of a patient blood management program on utilization of all three major blood components

Rajiv N. Thakkar, K. H Ken Lee, Paul Michael Ness, Tyler L. Wintermeyer, Daniel J. Johnson, Jing Liu, Anjuli Rajprasad, Amy M Knight, Pat A. Wachter, Renee Demski, Steven Mark Frank

Research output: Contribution to journalArticlepeer-review

31 Scopus citations


BACKGROUND: Although patient blood management (PBM) programs clearly reduce transfusion overuse, the relative impact on red blood cell (RBC), plasma, and platelet (PLT) utilization is unclear. STUDY DESIGN AND METHODS: A retrospective analysis of electronic records was conducted at a medium-sized academic hospital to assess blood utilization for all inpatients admitted during 1-year periods before (n = 20,531) and after (n = 19,477) PBM efforts began in September 2014. Transfusion guideline compliance and overall utilization were assessed for RBCs, plasma, and PLTs. The primary PBM efforts included education on evidence-based transfusion guidelines, decision support in the computerized provider order entry system, and distribution of provider-specific reports showing comparison to peers for guideline compliance. Cost avoidance was determined by two methods (acquisition cost and activity-based cost), and clinical outcomes were compared during the two periods. RESULTS: For RBCs, orders outside hospital guidelines decreased (from 23.9% to 17.1%, p < 0.001), and utilization decreased by 12% (p < 0.035). For plasma and PLTs, both orders outside guidelines and utilization changed minimally. Overall cost avoidance was $181,887/year by acquisition cost (and from $582,039 to $873,058/year by activity-based cost), 93% of which was attributed to reduction in RBC utilization. Length of stay, morbidity, and mortality were unchanged. CONCLUSIONS: Our findings demonstrate a greater opportunity for reducing RBC compared to plasma and PLT utilization. A properly implemented PBM program has potential to reduce unnecessary transfusions and their associated risk and costs, without compromising clinical outcomes.

Original languageEnglish (US)
Pages (from-to)2212-2220
Number of pages9
Issue number9
StatePublished - Sep 1 2016

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Hematology


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