title: Changes in blood product utilization in a seven-hospital system after the implementation of a patient blood management program: A 9-year follow-up.
abstract: OBJECTIVE
  To analyze changes in red blood cell (RBC), platelet (PLT), and plasma transfusion volumes 9 years after the implementation of a multifaceted patient blood management (PBM) program across multiple hospitals.
  
  
  METHODS
  Between fiscal years 2007 and 2015, the annual transfusion volumes for seven hospitals in a regional healthcare system were analyzed by hospital, and between 2014 and 2015, by four service lines including emergency department, intensive care unit (ICU), medical/surgical ward, and operating room at each hospital. The number of units of RBCs administered to transfused recipients on the wards and in ICUs was also enumerated.
  
  
  RESULTS
  For these seven hospitals combined, there was a 29.9% reduction in the number of RBCs transfused between 2007 and 2015, a 24.8% reduction in plasma units, and a 25.7% reduction in PLT units. The two largest hospitals saw some of the largest reductions in RBC transfusions (40.1, 25.1%), and plasma transfusions (26.1, 33.8%), and one of those hospitals had a 49.5% reduction in PLT transfusions. Smaller-sized hospitals also had reductions in transfusion volumes, while some volumes increased at hospitals when new or expanded clinical services were introduced. The number of RBC units per transfused recipient was generally between 1.5 and 2 units on the wards and slightly higher in the ICUs.
  
  
  CONCLUSIONS
  Although the overall volume of transfusions has generally decreased at each hospital site over time, the appropriateness of the administered transfusions cannot be evaluated by these data.
  
  
  CONCLUSIONS
  The system-wide implementation of a PBM program has reduced transfusion volumes.
authors: a Department of Anesthesiology , University of Pittsburgh , PA , USA.
authors: Nicole M
authors: NM
authors: Verdecchia
authors: b The Donald D. Wolff Jr Center for Quality, Safety, and Innovation at UPMC , Pittsburgh , PA , USA.
authors: Mary Kay
authors: MK
authors: Wisniewski
authors: a Department of Anesthesiology , University of Pittsburgh , PA , USA.|c Department of Bioengineering and the McGowan Institute for Regenerative Medicine , University of Pittsburgh , PA , USA.
authors: Jonathan H
authors: JH
authors: Waters
authors: d Department of Pathology , University of Pittsburgh , PA , USA.|e The Institute for Transfusion Medicine , Pittsburgh , PA , USA.
authors: Darrell J
authors: DJ
authors: Triulzi
authors: f Departments of Surgery and Critical Care Medicine , University of Pittsburgh , PA , USA.
authors: Louis H
authors: LH
authors: Alarcon
authors: d Department of Pathology , University of Pittsburgh , PA , USA.|e The Institute for Transfusion Medicine , Pittsburgh , PA , USA.
authors: Mark H
authors: MH
authors: Yazer
mesh_terms: D001771:Blood Banks / Q000592:standards*; D017707:Erythrocyte Transfusion / Q000592:standards*; D005500:Follow-Up Studies; D006761:Hospitals; D006801:Humans; D012189:Retrospective Studies
keywords: Emergency department; Intensive care unit; Operating room; Patient blood management; Plasma; Platelet; Red blood cell; Reduction; Ward