Contributions
Abstract: PB2229
Type: Publication Only
Background
The need for blood in hospitals continues to exceed the volume collected by the transfusion services. The gross over-ordering of blood, in excess of actual and anticipated needs leads to substantial costs and a burden to the transfusion services. In addition, over-ordering leads to non-availability of cross-matched units for other patients who might be in urgent need of transfusion.
Aims
We are aiming to reduce the Cross-match-to-transfusion ratio (C:T ratio) & improve blood utilization in Mafraq Hospital.
Methods
In 2011 the ordering practice at Mafraq Hospital, a designated Trauma Centre, had been evaluated. Data collected retrospectively over a one year period and a C:T ratio adopted by the American Association of Blood Bank was calculated for all various subspecialties including Surgery, Internal Medicine, Pediatrics and Obstetrics and Gynecology. All procedures related to hospital transfusion practice been retrieved and re-evaluated to address gaps. Policy of maximum surgical blood ordering (MSBO) was implemented based upon both results of audits and by discussion and agreement between medical teams. Focused training and education has been followed to increase the awareness of the health care workers. Plus monitoring of C:T ratio on monthly basis, blood bank team had arranged meetings with the departments that were over-ordering cross-matches to explain that group & save test is a safe, effective and financially beneficial strategy. Communicating with the physicians had been the most challenging aspect of implementing the policy changes.Regular audits had been conducted to measure the compliance and effectiveness of the blood management practice.
Results
Compared to the international guidelines, C:T ratios in 2010 was beyond the acceptable target and ranged between 2.5 to 3.2 highlighting the over-ordered cross-matched blood in certain sub-specialties. This practice of ordering was probably because of the fear that blood will not be available, if needed. Following implementation of control and continuous monitoring measures while establishing proper procedures such us transfusion guidelines, administration of blood and blood products and Maximum Surgical Ordering Practice, Mafraq blood bank ,supported by the Transfusion and Tissue & Quality & Patient Safety Committees, achieved a great success in reducing C:T ratio <2 all through 2016 Fig1,2. The reduction of C:T ratio had improved blood inventory control and reduced the workload of the blood bank staff. Because fewer units of cross-matched PRBC are being ordered, the blood bank has been able to decrease the number of units of blood stocked in house and hence decreasing the number of expired units &reducing money loss Fig3,4. The savings in technologist time is particularly significant since the blood bank is most of the time at a minimal staffing level.
Conclusion
There is a tendency to order blood in excess, either by asking for an increased number of units
Session topic: 30. Transfusion medicine
Abstract: PB2229
Type: Publication Only
Background
The need for blood in hospitals continues to exceed the volume collected by the transfusion services. The gross over-ordering of blood, in excess of actual and anticipated needs leads to substantial costs and a burden to the transfusion services. In addition, over-ordering leads to non-availability of cross-matched units for other patients who might be in urgent need of transfusion.
Aims
We are aiming to reduce the Cross-match-to-transfusion ratio (C:T ratio) & improve blood utilization in Mafraq Hospital.
Methods
In 2011 the ordering practice at Mafraq Hospital, a designated Trauma Centre, had been evaluated. Data collected retrospectively over a one year period and a C:T ratio adopted by the American Association of Blood Bank was calculated for all various subspecialties including Surgery, Internal Medicine, Pediatrics and Obstetrics and Gynecology. All procedures related to hospital transfusion practice been retrieved and re-evaluated to address gaps. Policy of maximum surgical blood ordering (MSBO) was implemented based upon both results of audits and by discussion and agreement between medical teams. Focused training and education has been followed to increase the awareness of the health care workers. Plus monitoring of C:T ratio on monthly basis, blood bank team had arranged meetings with the departments that were over-ordering cross-matches to explain that group & save test is a safe, effective and financially beneficial strategy. Communicating with the physicians had been the most challenging aspect of implementing the policy changes.Regular audits had been conducted to measure the compliance and effectiveness of the blood management practice.
Results
Compared to the international guidelines, C:T ratios in 2010 was beyond the acceptable target and ranged between 2.5 to 3.2 highlighting the over-ordered cross-matched blood in certain sub-specialties. This practice of ordering was probably because of the fear that blood will not be available, if needed. Following implementation of control and continuous monitoring measures while establishing proper procedures such us transfusion guidelines, administration of blood and blood products and Maximum Surgical Ordering Practice, Mafraq blood bank ,supported by the Transfusion and Tissue & Quality & Patient Safety Committees, achieved a great success in reducing C:T ratio <2 all through 2016 Fig1,2. The reduction of C:T ratio had improved blood inventory control and reduced the workload of the blood bank staff. Because fewer units of cross-matched PRBC are being ordered, the blood bank has been able to decrease the number of units of blood stocked in house and hence decreasing the number of expired units &reducing money loss Fig3,4. The savings in technologist time is particularly significant since the blood bank is most of the time at a minimal staffing level.
Conclusion
There is a tendency to order blood in excess, either by asking for an increased number of units
Session topic: 30. Transfusion medicine