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J Hosp Med. 2014 Jan;9(1):60-5. doi: 10.1002/jhm.2116. Epub 2013 Nov 26.

Patient-centered blood management.

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  • 1Department of Hospital Medicine, Geisinger Medical Center, Danville, Pennsylvania.

Abstract

BACKGROUND:

Transfusions are common in hospitalized patients but carry significant risk, with associated morbidity and mortality that increases with each unit of blood received. Clinical trials consistently support a conservative over a liberal approach to transfusion. Yet there remains wide variation in practice, and more than half of red cell transfusions may be inappropriate. Adopting a more comprehensive approach to the bleeding, coagulopathic, or anemic patient has the potential to improve patient care.

METHODS:

We present a patient-centered blood management (PBM) paradigm. The 4 guiding principles of effective PBM that we present include anemia management, coagulation optimization, blood conservation, and patient-centered decision making.

RESULTS:

PBM has the potential to decrease transfusion rates, decrease practice variation, and improve patient outcomes.

CONCLUSION:

PBM's value proposition is highly aligned with that of hospital medicine. Hospitalists' dual role as front-line care providers and quality improvement leaders make them the ideal candidates to develop, implement, and practice PBM.

© 2013 Society of Hospital Medicine.

[PubMed - indexed for MEDLINE]
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