title: Improving the appropriateness of red blood cell transfusions in patients undergoing orthopedic surgery.
abstract: Orthopedic surgery is a common procedure among the elderly, and patients are at risk of receiving unnecessary blood transfusions. The goals of this project were to analyze current transfusion practices, identify opportunities for improvement, implement hospital-based quality improvement programs, and measure their impact on transfusion practices. Our aims were to decrease unnecessary transfusions and overall exposure to blood products. Data were abstracted from medical records, at baseline and postintervention. The results demonstrated significant improvements: a 55% decrease in avoidable transfusion events (from 42% to 19%, p < .001) and a decrease in the pre-transfusion hematocrit from a baseline of 29% to 26.9% in the postintervention period (p < .01). The percentage of single unit transfusion events increased from 71.9% to 77.2% (p = .05). These results suggest that the interventions had a significant impact on the use of blood. In the long term, these results should translate into cost savings and improved patient outcomes.
authors.affiliation: Massachusetts Peer Review Organization, USA.
authors.forename: A M
authors.initials: AM
authors.lastname: Audet
authors.forename: C
authors.initials: C
authors.lastname: Andrzejewski
authors.forename: M
authors.initials: M
authors.lastname: Popovsky
mesh_terms: D000704:Analysis of Variance; D019644:Arthroplasty, Replacement, Hip; D019645:Arthroplasty, Replacement, Knee; D016009:Chi-Square Distribution; D002985:Clinical Protocols; D017707:Erythrocyte Transfusion / Q000706:statistics & numerical data*; D006801:Humans; D008404:Massachusetts; D006278:Medicare / Q000592:standards; D010043:Outcome and Process Assessment, Health Care; D011366:Professional Review Organizations; D011785:Quality Assurance, Health Care; D019984:Quality Indicators, Health Care; D014481:United States