Data-Informed Patient Blood Management Saves $1.2M

THE IMPORTANCE OF PATIENT BLOOD MANAGEMENT

Nearly 29,000 units of red blood cells (RBC) are needed every day in the U.S.¹Blood transfusions are a vitally important therapy but remain one of the most overused procedures.²Blood products are often at critically low inventory levels, increasing the pressure for organizations to ensure effective patient blood management.

THE BURDEN OF IDENTIFYING IMPROVEMENT OPPORTUNITIES

CHNw sought to improve the effectiveness of patient blood management to ensure that costly, limited blood products were appropriately used for patients who could benefit the most from the therapy. Still, the organization lacked data and analytics, impeding improvement efforts.

Obtaining the data required to evaluate performance and identify improvement opportunities required substantial time and were burdensome. Data were spread across multiple sources, including the EHR, blood bank, and financial department. When CHNw finally obtained data from these sources, it often experienced data-quality issues. Data from different sources sometimes conflicted and were difficult to reconcile. CHNw needed a solution that would provide timely, actionable insights that could be used to better manage limited blood supplies and improve performance.

DATA FUELS EFFECTIVE BLOOD MANAGEMENT

CHNw chose to use the Health Catalyst® Data Operating System (DOS™) platform and a robust suite of analytics applications, including the Blood Utilization analytics accelerator and Healthcare.AI, to gain access to the high-value data and analytics, and actionable insights required to improve patient blood management effectiveness.

CHNw使用血液利用分析加速器和医疗保健。人工智能可以看到、了解和改善患者的血液管理。Using the analytics accelerator, the organization can quickly and effectively visualize the:

• Number of transfusions ordered and given, including the reason for transfusion and clinical criteria.
• Percentage of blood transfused related to hemoglobin (Hgb) level.
• Total volume of transfusions by component.
• Total units transfused by 100 discharges, by specialty, by procedure, by ordering provider, and diagnosis.
• Quantification of savings opportunity over time.
• 输血反应。
• 坚持关键输血-护理最佳做法。

With the new insights gained from the analytics application, the organization targeted reducing the RBC utilization rate and ensuring adherence to transfusion best practices. It developed and implemented a standard blood product order set, including a restrictive transfusion strategy by Hgb level. CHNw also provided education and support for registered nurses and providers about using the order set and education about the most recent patient blood management best practices and communicated the expectation that providers enter blood orders using computerized provider order entry.

新的见解还支持组织在EHR中更新决策支持的决定，以确保警报出现在正确的供应商的正确工作流中。如果没有Hgb，警报将通知订购提供者，并提示提供者订购并在订购输血前检查Hgb。如果Hgb大于7-8 g/dL，警告鼓励提供者重新考虑输血，表明不建议在血液动力学稳定的患者输血。如果需要紧急/大量输血，可以绕过警报。

Healthcare.AI integration provides one-button augmented intelligence within the Blood Utilization analytics accelerator, enabling CHNw to produce higher-quality, faster insights. CHNw trusts the high-value and high-quality data in the analytics application. Data are integrated from multiple source systems, integrated, and aggregated so CHNw can immediately identify and manage variations in practice and performance trends over time. Integrated statistical process control charts support CHNw quickly drawing more accurate and consistent conclusions about performance and improvement opportunities. The organization uses its rich, high-quality data and analytics to engage providers in continually improving patient blood management effectiveness.

“Heal世界杯葡萄牙vs加纳即时走地th Catalyst血液利用分析加速器为我们提供了高质量的数据和分析，从而真正理解我们的性能并推动改进。我们成功地减少了每年输注的红细胞数量，节省了120多万美元。”

M. Danielle Dillon, MHL, BSN, RN, CCRN-K, Blood Management Director, Quality & Safety, Community Health Network

RESULTS

CHNw’s data-informed patient blood management has decreased unnecessary transfusions and improved the management of a costly, limited resource resulting in:

• >$1.2M in cost savings, the result of decreased utilization of blood products—1,500 RBCs avoided.
• 每年避免了数百个小时的人工数据审查，从而产生了专注于性能改进的能力。

The analytics accelerator has also enabled CHNw to identify previously hidden improvement opportunities. For example, because of the high-quality data in the analytics accelerator, the organization was able to identify opportunities to decrease the waste of fresh frozen plasma.

WHAT’S NEXT

CHNw is continuing to improve the effectiveness of patient blood management. The organization is implementing new processes to improve preoperative anemia management for patients undergoing elective surgery. Additionally, CHNw is standardizing a provider champion-driven approach to conducting crucial conversations with providers who do not have clinical indications in ordering blood products and escalating trends via appropriate safety event reporting mechanisms. The organization is also optimizing massive transfusion protocol use and practice in conjunction with OR, maternity, and education leaders.

REFERENCES

1. American Red Cross. (n.d.). U.S. blood supply facts. Retrieved fromhttps://www.redcrossblood.org/donate-blood/how-to-donate/how-blood-donations-help/blood-needs-blood-supply.html
2. Sadana, D., et al. (2018). Promoting high-value practice by reducing unnecessary transfusions with a patient blood management program.JAMA Intern Med.,178(1), 116–122. Retrieved fromhttps://pubmed.ncbi.nlm.nih.gov/29159367/

ADDITIONAL READING

• $17.4M Saved Through Analytics-Driven Patient Blood Management Improvements
• Engaging Providers to Transform Blood Transfusion Practices
• Blood Conservation Program Yields Millions of Dollars in Savings
• Consistent Improvement Methodology Accelerates Healthcare Outcomes
• Closing Care Gaps at the Point-of-Care Yields 4X Value Realization