Application of Six Sigma/CAP methodology: controlling blood-product utilization and costs.
Blood-product components are a limited commodity whose cost is rising. Many patients benefit from their use, but patients who receive transfusions face an unnecessary increased risk for developing infections; fatal, febrile, or allergic reactions; and circulatory overload. To improve patient care, safety, and resource stewardship, transfusion practices must be evaluated for appropriateness (Wilson et al. 2002). A multihospital health system undertook a rigorous study of blood-product utilization patterns and management processes to address cost-control problems in the organization. The system leveraged two process improvement tools widely implemented outside of the healthcare industry: (1) Six Sigma methodology to identify blood-utilization drivers and to standardize transfusion practice, and (2) change acceleration process model to drive effective change. The initiative resulted in a decreased rate of inappropriate transfusions of packed red blood cell from 16 percent to less than 5 percent, improved clinician use of a blood-component order form, establishment of internal benchmarks, enhanced laboratory-to-clinician communication, and better blood-product expense control. The project further demonstrated how out-of-industry tools and methodologies can be adopted, adapted, and systematically applied to generate positive change (Black and Revere 2006).
Neri
Robert A
RA
Virtua Health, Inc., Marlton, New Jersey, USA.
Mason
Cindy E
CE
Demko
Lisa A
LA
D016913:Blood Component Transfusion / Q000191:economics* / Q000592:standards / Q000706:statistics & numerical data*; D003363:Cost Control / Q000379:methods; D006801:Humans; D009096:Multi-Institutional Systems; D017749:Total Quality Management / Q000379:methods*; D014481:United States