Effective implementation of a patient blood management programme for platelets.

Abstract

Objectives: To implement a patient blood management (PBM) programme in platelet transfusion.

Aims: To improve the appropriate use of blood components, reduce wastage and generate savings.

Background: PBM is a multidisciplinary, evidence-based approach to optimising the care of patients who need blood transfusion and to use blood products appropriately. Strategies for PBM ensure that patients receive the best possible treatment with the transfusion of components when indicated, at the same time avoiding or reducing unnecessary transfusions. Typically, PBM initiatives have addressed the use of red cells. PBM initiatives in platelets (PBM-P) are an important aspect of Transfusion Medicine.

Methods: We present data from an initiative for PBM-platelets (PBM-P) comprising a service improvement programme through the role of a 'platelet co-ordinator' (PBM-Pc) to optimise the use of platelets in a large complex tertiary care hospital in a National Health Service (NHS) setting.

Results: Analysis at 18 months of the role showed sustained improvement in compliance with quality standards defined by British Committee for Standards in Haematology (BCSH) guidelines and significant financial savings due to improved use and reduced wastage. The appropriate use of platelets increased by 17, 23 and 18% in the prophylactic, pre-procedure and peri-procedure categories, respectively. Importantly, despite concurrent increases of patient activity, platelet issues and cost reduced by 21% over the period of analysis.

Conclusions: Our model has been efficacious in delivering the effective stewardship of platelets and can be successfully implemented in NHS.