title: Bloodless surgery: establishment of a program for the special medical needs of the Jehovah's witness community--the gynecologic surgery experience at a community hospital.
abstract: OBJECTIVE
  My purpose was to describe the rationale behind the establishment of a hospital-based program instituted to enhance the health of the Jehovah's Witness community and to evaluate patient profiles and outcomes of gynecologic patients treated surgically at our institution, during the past 5 years, whose intake was through the Bloodless Surgery Program and who were not accepting of blood or most blood products. I further describe how a coordinated program dedicated to serving this particular population might improve outcomes and patient satisfaction.
  
  
  METHODS
  A retrospective review of the charts of 89 patients, all Jehovah's Witnesses, who were enrolled through the Bloodless Surgery Program and underwent gynecologic surgery involving at least 1 night's hospitalization at our institution between January 1, 1993, and December 31, 1997, was performed. A comparison of patient length of stay, hospital charges, and surgical blood loss, in a subset of 41 patients who underwent abdominal hysterectomy, with a cohort of patients not affiliated with the Jehovah's Witnesses or the Bloodless Surgery Program was performed. Data regarding patient satisfaction were obtained through surveys and are presented.
  
  
  RESULTS
  Patients enrolled through the Bloodless Surgery Program and undergoing abdominal hysterectomy were significantly younger (average age 43.4 vs 47.7 years) and incurred significantly lower hospital charges (average cost $8754 vs $9539). No significant difference between the group studied and the control group could be found in average length of stay or the average change between preoperative and postoperative hemoglobin levels. Data from patient satisfaction surveys suggest a high level of satisfaction with the Bloodless Surgery Program.
  
  
  CONCLUSIONS
  A program dedicated to the special needs of the Jehovah's Witness community can be instituted in a community-based hospital with no evidence of increased morbidity, as evidenced by length of stay, hospital charges, and surgical blood loss, in a gynecologic patient population. Development of such programs is associated with a high level of patient satisfaction and the potential for improved patient care.
authors.affiliation: 3niDepartment of Obstetrics and Gynecology, Legacy Good Samaritan Hospital, Portland, USA.
authors.forename: R M
authors.initials: RM
authors.lastname: deCastro
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001803:Blood Transfusion; D002835:Christianity; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D017721:Hospital Costs; D006764:Hospitals, Community; D006801:Humans; D007044:Hysterectomy / Q000191:economics / Q000379:methods*; D007902:Length of Stay; D008875:Middle Aged; D012189:Retrospective Studies; D011795:Surveys and Questionnaires
chemical_list: D006454:Hemoglobins