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JAMA Intern Med. 2018 Jan 1;178(1):116-122. doi: 10.1001/jamainternmed.2017.6369.

Promoting High-Value Practice by Reducing Unnecessary Transfusions With a Patient Blood Management Program.

Author information

1
Department of Internal Medicine, Cleveland Clinic Foundation, Cleveland, Ohio.
2
Department of Internal Medicine, NYU Langone Health, New York, New York.
3
Department of Anesthesiology/Critical Care Medicine, The Johns Hopkins Medical Institutions, Baltimore, Maryland.
4
Johns Hopkins Health System Blood Management Program, Department of Anesthesiology/Critical Care Medicine, The Johns Hopkins Medical Institutions, Baltimore, Maryland.

Abstract

Although blood transfusion is a lifesaving therapy for some patients, transfusion has been named 1 of the top 5 overused procedures in US hospitals. As unnecessary transfusions only increase risk and cost without providing benefit, improving transfusion practice is an effective way of promoting high-value care. Most high-quality clinical trials supporting a restrictive transfusion strategy have been published in the past 5 to 10 years, so the value of a successful patient blood management program has only recently been recognized. We review the most recent transfusion practice guidelines and the evidence supporting these guidelines. We also discuss several medical societies' Choosing Wisely campaigns to reduce or eliminate overuse of transfusions. A blueprint is presented for developing a patient blood management program, which includes discussion of specific methods for optimizing transfusion practice.

PMID:
29159367
DOI:
10.1001/jamainternmed.2017.6369
[Indexed for MEDLINE]

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