Reducing blood utilization by implementation of a type-and-screen transfusion policy a single-institution experience.
OBJECTIVE
The Blood Utilization Committee implemented a standardized protocol for the preoperative blood order for cardiac patients. The aim of our study was to assess the improvement in blood utilization using the crossmatch to transfusion ratio (C:T).


METHODS
Four months of retrospective data were collected, which included all RBC crossmatch requests and all RBC units transfused. Similar data were gathered for the period of the intervention. The difference in C:T was calculated.


RESULTS
The retrospective group had 166 patients for whom blood products were ordered. There were 560 crossmatch requests and 237 transfused RBC units with a C:T of 2.36. The prospective group had 127 patients with 297 crossmatch requests, 190 transfused units, and a C:T of 1.56. There was a statistically significant difference in the C:T. The cost difference was $12,244.00.


CONCLUSIONS
Implementing exact guidelines, with the introduction of a type-and-screen concept, allowed more efficient blood usage.
From the Departments of Pathology, sarah.alghamdi@msmc.com.
Sarah
S
Alghamdi
From the Departments of Pathology.
Betzabel
B
Gonzalez
From the Departments of Pathology.
Lydia
L
Howard
Internal Medicine.
Simon
S
Zeichner
Cardiac Surgery, and.
Angelo
A
LaPietra
Anesthesiology, Mount Sinai Medical Center, Miami Beach, FL.
Gerald
G
Rosen
Anesthesiology, Mount Sinai Medical Center, Miami Beach, FL.
Guillermo
G
Garcia
Cardiac Surgery, and.
Joseph
J
Lamelas
Internal Medicine.
Robert
R
Goldszer
D001771:Blood Banks; D001788:Blood Grouping and Crossmatching / Q000191:economics / Q000706:statistics & numerical data*; D001803:Blood Transfusion / Q000191:economics / Q000706:statistics & numerical data*; D003362:Cost-Benefit Analysis; D006801:Humans; D010818:Practice Patterns, Physicians'; D012189:Retrospective Studies; D013903:Thoracic Surgery / Q000191:economics / Q000331:legislation & jurisprudence
Blood utilization; C:T ratio; Transfusion medicine; Type and screen