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Evaluation & the Health Professions
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Improving the Appropriateness of Red Blood Cell Transfusions in Patients Undergoing Orthopedic Surgery

Anne-Marie Audet

Massachusetts Peer Review Organization

Chester Andrzejewski

Baystate Medical Center

Mark Popovsky

American Red Cross, Harvard Medical School

Othopedic surgery is a common procedure among the elderly, and patients are at risk of receiving unnecessaryblood transfusions. The goals of this project were to analyze current transfusion practices, identify opportunities for improvement, implement hospital-based quality improvement programs, and measure their impact on transfusion practices. Our aims were to decrease unnecessary transfusions and overall exposure to blood products. Data were abstractedfrom medical records, at baseline and postintervention. The results demonstrated significant improvements: a 55% decrease in avoidable transfusion events (from 42% to 19%o, p < .001) and a decrease in the pre-transfusion hematocritfrom a baseline of 29% to 26.9% in the postintervention period (p <.01). The percentage of single unit transfusion events increased from 71.9% to 77.2% (p = .05). These results suggest that the interventions had a significant impact on the use of blood. In the long term, these results should translate into cost savings and improved patient outcomes.

Evaluation & the Health Professions, Vol. 21, No. 4, 487-501 (1998)
DOI: 10.1177/016327879802100407
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