The most recent comprehensive survey by the Association for the Advancement of Blood and Biotherapies (AABB) of patient blood management (PBM) practices was conducted in 2013. Since that time, much has changed regarding the transfusion practices and guidelines published by various professional organizations. These changes include the AABB’s new clinical practice guidelines, promotion of single unit transfusions, and revised platelet transfusion thresholds. During the past decade, use of computerized physician order entry and best practice alerts have widely increased in healthcare and the parallels with PBM will be examined. The development of a culture of PBM must involve educational programs. There will be a discussion on who is part of these programs. The use of alternates to transfusion will be considered including: prothrombin complex concentrates, iron supplementation, and erythrocyte stimulating agents, among others. Are hospitals using perioperative tools to minimize transfusion? Implementation of blood sparing conservation techniques such as acute normovolemic hemodilution, intraoperative cell salvage and postoperative blood collection will be discussed. There will be a conversation on mitigation strategies to avoid hospital acquired anemia (HAA) that includes: reducing frequency of blood draws, use of pediatric tubes and devices such as central lines that eliminate blood discard. Metrics used to determine PBM program success will be explored. There will be a discussion of the ability of PBM program to treat those patients where blood is not an option (BNAO). Finally, the frequency of informed consents for blood transfusion as a standalone document or incorporated into the admission consent will close the session. If you have a formal/informal PBM program and want to see how your program/hospital/transfusion service compares to others both nationally and internationally and how you can make it more effective and successful, this session is a must see.
All relevant financial relationships have been mitigated.
Examine transfusion thresholds reported by the survey and how they compare with the AABB or other professional guidelines.
Determine how widely alternatives to transfusion are being used in clinical practice.
Summarize the findings as they pertain to perioperative cell salvage, mitigation strategies to minimize HAA, the ability of PBM programs to treat BNAO patients, and the format of informed consent documents (standalone vs. part of the admission process).
Recognize areas for improvement to their present PBM program to make it more effective.