Blood transfusions are one of the top five most overused procedures, in addition to being the most common procedure performed in U.S. hospitals. A five-year effort across the Johns Hopkins Health System to reduce unnecessary blood transfusions has also resulted in more than $2 million savings annually. A summary of the blood management program, published in the Online First edition of Anesthesiology, details the development and implementation of the program, which can be adopted by other health systems.
The new patient blood management (PBM) program was launched in January 2012 at The Johns Hopkins Hospital, with a clinical education program. The educational outreach consisted of live, in-person Grand Rounds presentations to various clinical departments to inform physicians, nurses and others about hospital transfusion policy guidelines and the results of eight published landmark studies that support reduced use of transfusions. The single most effective intervention, says Frank, was the "Why give 2 when 1 will do?" campaign to encourage single-unit transfusions, which resulted in a 49% decrease in multiunit orders. The number of red blood cell units transfused per 1,000 patients decreased by 19.8%, while plasma transfusions decreased by 38.9% and platelets by 15.6%.