Evidence map›Paper›PMID 36752098›Full record

ArticleTransfusion2023

Reducing perioperative red blood cell unit issue orders, returns, and waste using failure modes and effects analysis.

Sunny S Lou, Megan M Dewey, Mara L Bollini, Derek R Harford, Cindy Ingold, Troy S Wildes, Tracey W Stevens, Jackie L Martin, Brenda J Grossman, Ivan Kangrga

Open access · bronzeAbstract read
In one paragraph

Article in Transfusion, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.6field-weighted citation impact, top 39% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 6 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 2 institutions in 1 country.

Sunny S LouDepartment of Anesthesiology, Washington University School of Medicine, St Louis, Missouri, USA.ORCID 0000-0002-4215-605X
Megan M DeweyDepartment of Anesthesiology, Washington University School of Medicine, St Louis, Missouri, USA.
Mara L BolliniDepartment of Anesthesiology, Washington University School of Medicine, St Louis, Missouri, USA.
Derek R HarfordDepartment of Anesthesiology, Washington University School of Medicine, St Louis, Missouri, USA.
Cindy IngoldTransfusion Services, Barnes-Jewish Hospital, St Louis, Missouri, USA.
Troy S WildesDepartment of Anesthesiology, Washington University School of Medicine, St Louis, Missouri, USA.
Tracey W StevensDepartment of Anesthesiology, Washington University School of Medicine, St Louis, Missouri, USA.
Jackie L MartinPerioperative Services, Barnes-Jewish Hospital, St Louis, Missouri, USA.
Brenda J GrossmanTransfusion Services, Barnes-Jewish Hospital, St Louis, Missouri, USA.ORCID 0000-0002-1500-8211
Ivan KangrgaDepartment of Anesthesiology, Washington University School of Medicine, St Louis, Missouri, USA.
Washington University in St. Louis · USBarnes-Jewish Hospital · US

Funding

TRAINING PROGRAM IN ANESTHESIOLOGY RESEARCHT32GM108539 · NIGMS · WASHINGTON UNIVERSITY · PI Aaron J Norris · 2014 to 2026
$4.9M
NIGMS NIH HHS T32 GM108539
6 · The paper itself

Abstract

backgroundSurgical transfusion has an outsized impact on hospital-based transfusion services, leading to blood product waste and unnecessary costs. The objective of this study was to design and implement a streamlined, reliable process for perioperative blood issue ordering and delivery to reduce waste. STUDY DESIGN AND

methodsTo address the high rates of surgical blood issue requests and red blood cell (RBC) unit waste at a large academic medical center, a failure modes and effects analysis was used to systematically examine perioperative blood management practices. Based on identified failure modes (e.g., miscommunication, knowledge gaps), a multi-component action plan was devised involving process changes, education, electronic clinical decision support, audit, and feedback. Changes in RBC unit issue requests, returns, waste, labor, and cost were measured pre- and post-intervention.

resultsThe number of perioperative RBC unit issue requests decreased from 358 per month (SD 24) pre-intervention to 282 per month (SD 16) post-intervention (p < .001), resulting in an estimated savings of 8.9 h per month in blood bank staff labor. The issue-to-transfusion ratio decreased from 2.7 to 2.1 (p < .001). Perioperative RBC unit waste decreased from 4.5% of units issued pre-intervention to 0.8% of units issued post-intervention (p < .001), saving an estimated $148,543 in RBC unit acquisition costs and $546,093 in overhead costs per year. DISCUSSION: Our intervention, designed based on a structured failure modes analysis, achieved sustained reductions in perioperative RBC unit issue orders, returns, and waste, with associated benefits for blood conservation and transfusion program costs.

Indexed as

Erythrocyte TransfusionHealthcare Failure Mode and Effect AnalysisBlood BanksBlood TransfusionErythrocytesHumansblood conservationperioperative blood managementsurgical transfusion practice

Identifiers

PMID36752098
PMCPMC10089960
OpenAlexW4319460527

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.