Patient Blood Management Type and Screen Protocol Optimizing

1. We recollected data from 2009 till 2014. We compared the previous five years period (P1: 2009-2013) vs 2014
Data were obtained from Blood and Tissues Bank of Aragon (BASTA) data management program (NetBank Gold, IZASA, Spain):
- on units (U) of blood components (BC) transfused: packed red blood cell (RBC), autologous RBC (AT), inactivated fresh frozen plasma (FFP) and platelet
concentrates (PLT); RBC transfused per receptor (RBCT index), FFP transfusion Index (FFP units/RBC units*100), and PLT transfusion Index (PLT
units/RBC units*100) (mean ± standard deviation).
- Transfusion compatibility tests including: blood grouping (BG), irregular antibodies screening (IAS) and positive results; cross-matching (CM) and positive
results.
- Data on hospitalisations: stays, emergency Department activity and surgical activity were obtained from the hospital activity management program.
- Economic data were obtained from the hospital acquisition management program. Official public BC costs were obtained from health authority of Aragon
Government (BOA, July 29th 2013, regulating of the public prices of BTBA).
To present the preliminary health care and economic data from Project for Quality Improvement 2014: “Measures to
reduce blood component expiration rate of at Huesca Sector”.
Starting in 2014 the new protocol includes: progressive replacement of crossmatching and save by type & screening,
optimisation of sample validation, "restrictive" transfusion criteria, single-unit transfusion, and management of perioperative
anaemia.
Project for Quality Improvement 2014: “Measures to Reduce
Blood Component Expiration Rate of at Huesca Sector”
Dr J. A. García-Erce 1,2, B. Menéndez 1, S. Gómez, M. Borrel, M. Cebollero, A. Lezaun & J.
J. Marco
Haematology &Transfusion Service, Hospital San Jorge, Huesca, Spain; 1GIEMSA-AWGE, Spain; 2IdiPAZ49, Spain
INTRODUCTION & OBJECTIVE
PATIENTS & METHODS
RESULTS
 These preliminary data of the first year of the implementation of a more rational, individualised and evidence-based
use of BC, as recommended by the patient blood management paradigm, can be safe, effective and beneficial for
patients, from both healthcare provider and societal perspectives.
 We must reduce wasting BC due “over-date”. Blood Regional Center must supply youngest BC to help us.
 This year we have eliminated the universal cross matching and promote transfusion “one-by-one”.
 It is mandatory to reduce unnecessary BC request, CM, and transfusion.
COMMENTARY
As shown in Table/Figure 1, compared to 2008, the overall BC transfusion was reduced by 53.6%; and compared to 2012,
was reduced a 40%. As shown in Table 2, compared 2010, request, BG and IAS were significantly reduced 22%; and CM a
35%. The average of RBC requested has drop from 2.32 U/request till 1.72 U/request.
Regarding costs, the reduction in transfusion activity resulted in estimated savings in BC acquisition of € -321259.21 respect
to 2009; Savings in blood typing and compatibility testing amounted €-114691. Thus, overall estimated savings have been €
-450860,91.
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Table/Figure 1. Evolution blood component transfusion
2008 2009 2010 2011 2012 2013 2014
RBC 3833 3747 2931 2922 3036 2497 1872
FFP 311 361 220 191 215 90 116
PLT 308 237 206 124 196 107 74
AT 5 2 4
Total 4452 4345 3357 3237 3452 2696 2066
2008 2009 2010 2011 2012 2013 2014
BG 3035 2737 2628 2570 2476 2143
IAS 2983 2701 2612 2539 2455 2114
CM 7074 6180 5925 5715 5369 4042
Request 3115 3121 2811 2694 2620 2522 2186
Table 2. Evolution blood bank analytical activity
CADU-
CATED 2008 2009 2010 2011 2012 2013 2014
RBC 57 120 102 91 65 173 159
PLT 42 29 29 42 40 27 24
% RBC 1,49 3,20 3,48 3,11 2,14 6,92 8,48
% PLT 13,64 12,24 14,08 33,87 20,41 27,55 16,00
$ RBC 6684 14072 11962 10672 7623 20288 18646
$ PLT 15406 10638 10638 15406 14673 9904 8804
Cost 22091 24710 22599 26078 22295 30192 27450
Table 3. Evolution caducated BC
Figure 2: Estimated saving cost at 2014