What is Patient Blood Management and Where Do We Go From Here?

Course overview

The Joint Commission and the American Medical Association (AMA) identified blood transfusions as one of the five most "overused" interventions in healthcare; and at a 2012 National Summit on Overuse, issued a call to reduce blood transfusions. The variability in the use in cardiovascular surgery, for example, illustrates an inappropriate use of blood components in coronary artery bypass graft (CABG). Accordingly, patient blood management (PBM) programs developed initiatives to optimize erythropoiesis, minimize blood loss, and manage anemias in the surgical setting: preoperatively, intraoperatively, and postoperatively. A general therapeutic principle in PBM is to avoid empiric thresholds for RBC transfusion; and to administer transfusion on a unit-by-unit basis, according to patient symptoms. Choosing Wisely campaigns by medical societies as well as guidelines/recommendations for RBC transfusions, have resulted in substantial reductions in RBC utilization not only at individual medical centers, but also at the national and international levels. PBM has demonstrated that with improved patient safety (reduced exposure to transfusions) health care costs are also reduced; so that PBM now represents best practices and the standard of care. LEARNING OBJECTIVES: After this presentation, participants will be able to: - Identify available alternatives to blood transfusions in patient health care - Discuss how clinical decision support can improve blood product utilization - Review patient outcome metrics that are impacted by blood product utilization - Recognize that patient blood management (PBM)now represents best practices