Assembling a state‐wide patient blood management program as a standard of care: the Western Australian experience

Abstract

Background and ObjectivesPatient blood management (PBM) programs seek to improve clinical outcomes by avoiding unnecessary exposure to blood products. Recognising the risks of anaemia and immunomodulatory impacts of transfusions, PBM uses multidisciplinary and multimodal preventive measures to reduce the need for transfusions. To our knowledge, the Western Australian patient blood management program is the first specifically state‐government funded state‐wide program. We describe the implementation process and outcomes of this unique program from 2008 to 2015.Materials and MethodsImplementation was undertaken within four metropolitan tertiary hospitals using a multimodal, multidisciplinary team approach. This included appointment of hospital‐based PBM medical and nursing staff, education of clinical staff, provision of individualised data to support change in clinical practice, development of care pathways to ensure screening and correction of preoperative anaemia and involvement of primary care.ResultsThese interventions achieved a decline in transfusion rates and red cell utilisation despite an increasing population and hospital activity.ConclusionKey elements of program success included appointment of hospital‐based PBM staff, establishment of multidisciplinary committees with support from enthusiastic clinical staff, data provision to hospital departments and the national and international context in which this work occurred. Lessons learned included overestimating the value of staff education and culture change alone.