title: Perioperative blood ordering optimization process using information from an anesthesia information management system.
abstract: BACKGROUND
  As part of ongoing perioperative surgical home implantation process, we applied a previously published algorithm for creation of a maximum surgical blood order schedule (MSBOS) to our operating rooms. We hypothesized that using the MSBOS we could show a reduction in unnecessary preoperative blood testing and associated costs.
  
  
  METHODS
  Data regarding all surgical cases done at UC Irvine Health's operating rooms from January 1, 2011, to January 1, 2014 were extracted from the anesthesia information management systems (AIMS). After the data were organized into surgical specialties and operative sites, blood order recommendations were generated based on five specific case characteristics of the group. Next, we assessed current ordering practices in comparison to actual blood utilization to identify potential areas of wastage and performed a cost analysis comparing the annual hospital costs from preoperative blood orders if the blood order schedule were to be followed to historical practices.
  
  
  RESULTS
  Of the 19,138 patients who were categorized by the MSBOS as needing no blood sample, 2694 (14.0%) had a type and screen (T/S) ordered and 1116 (5.8%) had a type and crossmatch ordered. Of the 6073 procedures where MSBOS recommended only a T/S, 2355 (38.8%) had blood crossmatched. The cost analysis demonstrated an annual reduction in actual hospital costs of $57,335 with the MSBOS compared to historical blood ordering practices.
  
  
  CONCLUSIONS
  We showed that the algorithm for development of a multispecialty blood order schedule is transferable and yielded reductions in preoperative blood product screening at our institution.
authors.affiliation: Department of Anesthesiology & Perioperative Care, Irvine, California.
authors.forename: Joseph B
authors.initials: JB
authors.lastname: Rinehart
authors.affiliation: Department of Anesthesiology & Perioperative Care, Irvine, California.
authors.forename: Tiffany C
authors.initials: TC
authors.lastname: Lee
authors.affiliation: Department of Anesthesiology & Perioperative Care, Irvine, California.
authors.forename: Kayleigh
authors.initials: K
authors.lastname: Kaneshiro
authors.affiliation: Department of Pathology & Transfusion Medicine, University of California at Irvine, Irvine, California.
authors.forename: Minh-Ha
authors.initials: MH
authors.lastname: Tran
authors.affiliation: Department of Anesthesiology & Perioperative Care, Irvine, California.
authors.forename: Coral
authors.initials: C
authors.lastname: Sun
authors.affiliation: Department of Anesthesiology & Perioperative Care, Irvine, California.|The Child Study Center, Yale University, New Haven, Connecticut.
authors.forename: Zeev N
authors.initials: ZN
authors.lastname: Kain
mesh_terms: D000465:Algorithms; D000758:Anesthesia / Q000592:standards; D001071:Appointments and Schedules; D001788:Blood Grouping and Crossmatching / Q000592:standards; D001800:Blood Specimen Collection / Q000592:standards*; D001803:Blood Transfusion / Q000592:standards*; D063025:Health Information Management / Q000458:organization & administration / Q000592:standards*; D006801:Humans; D050316:Medical Order Entry Systems / Q000458:organization & administration / Q000592:standards*; D009873:Operating Rooms; D019990:Perioperative Care / Q000379:methods / Q000592:standards*