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CPOE Reducing I nappropriate Transfusions (CRIT) Collaborative.
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CPOE Reducing Inappropriate Transfusions (CRIT) Collaborative “The most cost effective opportunity to improve patient outcomes in the next quarter century will likely come, not from discovering new therapies but from discovering how to effectively deliver therapies that are known to be effective” Sean Berenholtz 2003
Collaborative Goals • Provide a venue for for multiple institutions to share experiences and projects surrounding blood utilization. • Test the hypothesis that CPOE tethered to CDS can improve and hasten the adoption of evidence based guidelines across multiple institutions. • Set the framework for future collaborations using effective decision support tools.
Meeting Agenda • Introductions. • Group Email. • Discuss institutional progress on the CRIT project, and gathering baseline data.
Evidence based algorithm Adams Pediatrics 2011
Decision Support Window Adams Pediatrics 2011
Total transfusions per patient day decreased from 0.075 to 0.05. Adams Pediatrics 2011
The average pre-transfusion Hgb decreased in both the PICU and acute care wards 7.55 7.14 9.8 8.7 Adams Pediatrics 2011
CDS Decreases Blood Transfusions on the Acute Care Wards Adams Pediatrics 2011
CDS Decreases Blood transfusions in the PICU Adams Pediatrics 2011
The Clinical Effect of CDS Is Sustainable Transfusions per patient day Adams- Unpublished
Proposed CRIT QI study design Data Collection 1 year Late Late Early Cohort Initiation Initiation Middle Middle Late Cohort
Baseline Data Inclusion criteria Exclusion Criteria Age 1m- 18 yrs Admitted to the hospital greater than 24 hrs Less than 1 month More than 18 yrs Congenital heart disease Hematology patients Data Total number of admissions Average pre-transfusion Hgb Transfusions Per patient day Defined as the most recent Hgb level drawn prior to transfusion All data should be broken down month to month starting January 2011
Baseline Data Total number of transfusions for patients that meet the inclusion criteria Hgb levels just prior to the transfusion Total number of patient days for patients that meet the inclusion criteria
Next meeting MondayTuesday May 29th9:00 AM Spread the word!