Moderadores: Dra. Dialina Brilhante, Dr. Carlos Falcão
Patient Blood Management (PBM) is worldwide recognized as the best strategy to avoid unnecessary transfusions and is a WHO recommendation for elective surgery since 2010. However, there is still limited implementation of PBM programs across hospitals, mainly due to the implicit challenges of its implementation. The purpose of the MAPBM project is to develop a maturity scorecard to serve the healthcare providers and services to assess, implement, measure and benchmark their PBM programs with the aim to reduce transfusion overuse and improve outcomes.
The scorecard model is based on a maturity matrix including the four work streams required in any transformation process – organization, processes, people/training and information systems. Calculation of quantitative process drivers according to the 3 pillars of PBM is obtained out of the information stored in clinical records of the five most blood consuming clinical processes: Hip and Knee arthroplasty surgery, Colo-rectal cancer resection surgery, Cardiac valve replacement surgery, hip fracture surgery, acute digestive haemorrhage.
Fifty-four Spanish hospitals, either private or public and of various sizes and complexities, from different Autonomous Communities throughout the country, participated in the MAPBM project in 2018. MAPBM has demonstrated the feasibility of transforming the wealth of evidence and PBM clinical recommendations into a set of KPIs that map the maturity in PBM of the hospitals. Many KPIs of PBM per process showed a good correlation with transfusion rate and length of stay, after there were adjusted by gender, age and comorbidity. However, in some hospitals calculation of indicators was limited by the availability of sufficient information in the databases.
After 4 years of experience the tool shows that can help hospitals to implement or upturn their own PBM program, facilitating them to manage the necessary improvements to reduce transfusion to the strictly necessary, improving patient care, health outcomes and reducing the costs.