What is Patient Blood Management?

1. What is Patient Blood Management?

2. Patient Blood Management (PBM) is the scientific use of safe and effective medical and surgical techniques designed to prevent anemia and decrease bleeding in an effort to improve patient outcome.

3. Why Patient Blood Management? • Improves patient safety by minimizing exposure to blood products • Reduces unnecessary hospital & patient care costs • Can reduce the risk of hospital-acquired complications and infections • Increases healthcare consumer participation in their treatment and care • Conserves a precious community resource

4. Helping Patients Become Educated Consumers

5. Patient Blood Management Surgical Strategies Optimize patient before surgery • Assess patient fitness for surgery • Correct bleeding disorders • Assess medications and herbs that increase bleeding • Correct anemia • Develop individualized plan of care Adapted from Goodnough LT, et al. Transfusion. 2003;43:668-676.

6. Patient Blood Management Surgical Strategies Minimize blood loss during surgery • Precise surgical technique • Surgical devices that control bleeding • Drugs that control bleeding • Minimally invasive technology • Anesthesia & Fluid management • Blood salvage

7. Patient Blood Management Surgical Strategies Maximize & Conserve blood production after surgery • Monitor and correct bleeding • Tolerance of permissive anemia • Increase patient blood production • Minimize blood sampling

8. Patient Blood Management Surgical Strategies: The Team Approach

9. Patient Blood Management Programs: Administrative and Clinical Essentials • Physician leadership and expertise • Core patient blood management team • Hospital-wide blood conservation policy and protocols • Continuing education for physicians and nurses • Healthcare consumer (patient) education

10. Patient Blood Management Programs: Changing the Culture Embraces a hospital-wide philosophy that every drop of blood counts

11. Patient Blood Management Programs: Integration PBM Programs are more successful when everyone works together • Administration • Physicians • Nurses • Patients

12. What Can Patients Do to Improve their Surgical Outcome? Is the patient willing to: • Investigate low red blood cell counts (anemia) and take the time to correct it with iron, vitamins or growth factors before coming to the hospital? • Ask their physician about blood management strategies early before surgery? • Consider the washing and recycling of their own blood during or after surgery if appropriate? • Ask their physician if prescribing minimal blood draws is appropriate for them?

13. What Can Patients Do to Improve their Surgical Outcome? Patient Blood Management starts in the physician’s office. Therefore, is the patient willing to: • Choose a doctor who will work with them? • Know and understand their blood counts? • Have their doctor explain the risks and benefits of their decision so they can make a truly informed choice before arriving at the hospital? • Choose a hospital with a PBM program e.g., www.sabm.org/programs?

14. Patient Blood Management Realities • Blood management options should be a part of making good health care choices • Building up blood counts before surgery may help one to avoid a blood transfusion • Sometimes, several blood management strategies can be used at the same time to avoid a blood transfusion • No single approach (drug, device, technique) is effective for everyone

15. Patient Blood Management Programs: Why Hospitals Embrace a PBM Culture* Responsive to public concern over blood safety Sustains a fragile blood supply Improves technology, devices, pharmaceuticals Imperative to reducing hospital costs & improves through-put (efficient patient discharge home) Improves physician skills Improves patient care Gives recognition as a PBM Center of Excellence Enhances need to be stay on the cutting edge *Cardiothoracic and Vascular Anesthesia, Vol 18, No 4 (August Supplement), 2004: pp 15S-17S+