title: Establishing a culture of blood management through education: a quality initiative study of postoperative blood use in CABG patients at Methodist DeBakey Heart & Vascular Center.
abstract: Blood management strategies are crucial in light of transfusion-related health risks to patients and the relative scarcity and cost of blood products. The authors describe a collaborative quality initiative to reduce blood use in their coronary artery bypass graft (CABG) population and other cardiovascular intensive care unit (CVICU) patients. A multidisciplinary team was engaged at all levels of patient care. The 2-part initiative involved a direct educational component emphasizing transfusion risk awareness and patient-centered blood management strategies accompanied by a data-based component that included monthly dissemination of blood product use to the relevant service lines. The authors observed a reduction in postoperative blood product use among CABG patients (14.3% decrease in the first year; 30.6% from 2006 to 2008) and an 18.2% reduction in blood product volume used in the entire CVICU, with no additional harm to patients and a trend toward better outcomes. This team-driven paradigm change has made blood management everyone's initiative.
authors.affiliation: Cardiovascular Intensive Care Unit, Methodist DeBakey Heart & Vascular Center, The Methodist Hospital, 6565 Fannin Street, B452, Houston, TX 77030-2707, USA. fmasud@tmhs.org
authors.forename: Faisal
authors.initials: F
authors.lastname: Masud
authors.forename: Karin
authors.initials: K
authors.lastname: Larson-Pollock
authors.forename: Christopher
authors.initials: C
authors.lastname: Leveque
authors.forename: Daynene
authors.initials: D
authors.lastname: Vykoukal
mesh_terms: D016913:Blood Component Transfusion / Q000379:methods; D001803:Blood Transfusion / Q000379:methods* / Q000706:statistics & numerical data; D001026:Coronary Artery Bypass / Q000379:methods*; D006801:Humans; D007318:Inservice Training / Q000458:organization & administration; D007362:Intensive Care Units / Q000458:organization & administration*; D015279:Organizational Culture; D010348:Patient Care Team / Q000458:organization & administration; D011182:Postoperative Care / Q000379:methods; D011787:Quality of Health Care / Q000458:organization & administration*