Prospective monitoring of plasma and platelet transfusions in a large teaching hospital results in significant cost reduction

• Published in: Transfusion (Philadelphia, Pa.) Pa.), 2010-02, Vol.50 (2), p.487-492
• Main Authors: Sarode, Ravindra, Refaai, Majed A., Matevosyan, Karen, Burner, James D., Hampton, Scott, Rutherford, Cynthia
• Format: Article
• Language: English
• Subjects: Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Blood Coagulation Tests; Blood Component Transfusion - economics; Blood Component Transfusion - utilization; Blood. Blood and plasma substitutes. Blood products. Blood cells. Blood typing. Plasmapheresis. Apheresis; Cost Savings; Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care; Evidence-Based Medicine; Guideline Adherence - economics; Guideline Adherence - utilization; Health Care Costs - statistics & numerical data; Hospital Departments; Hospitals, Teaching - economics; Hospitals, Teaching - organization & administration; Hospitals, Teaching - statistics & numerical data; Humans; Intensive care medicine; Medical sciences; Patient Admission - statistics & numerical data; Plasma; Platelet Transfusion - economics; Platelet Transfusion - utilization; Practice Guidelines as Topic; Retrospective Studies; Surgical Procedures, Operative - statistics & numerical data; Texas - epidemiology; Transfusions. Complications. Transfusion reactions. Cell and gene therapy; Trauma Centers - economics; Trauma Centers - organization & administration; Trauma Centers - statistics & numerical data; Triage - economics; Triage - utilization; Unnecessary Procedures - economics; Wounds and Injuries - epidemiology
• ISSN: 0041-1132; 1537-2995
• DOI: 10.1111/j.1537-2995.2009.02413.x

BACKGROUND: Plasma and platelets (PLTs) are often transfused to correct mild to moderately abnormal laboratory values. Our objective was to reduce unnecessary plasma and PLT transfusions to nonbleeding patients by prospective triage and education of end users in evidence‐based hemostasis and transfusion medicine practices. STUDY DESIGN AND METHODS: Using the Parkland Memorial Hospital's transfusion service and admission database as the data source, this study comprises the comparison of transfusion data on plasma and PLT use between pre‐ (2000‐2002) and posttriage (2003‐2006) periods. Yearly transfusion and wastage data on red blood cells (RBCs), plasma, and PLTs and yearly hospital admissions, trauma visits, and surgical procedures were extracted retrospectively for the study. RESULTS: The study revealed that implementation of triage resulted in a significant reduction of plasma (60%) and PLT (25%) transfusions, saving more than $3,000,000 over 4 years. CONCLUSIONS: Prospective triage and evidence‐based transfusion practice education reduced unnecessary plasma and PLT transfusions and health care costs.