Laboratory medicine contributions to patient blood management concepts

Abstract

AbstractBackground:A review of the literature shows that the role of laboratory diagnostics in the multidisciplinary concept of patient blood management (PBM) is underrepresented, so the contribution that laboratory diagnostics can make needs to be elucidated.Methods:The central objective of this study was to decrease the volume of blood drawn for laboratory diagnostics as part of a hospital quality management project focussed on increasing efficiency and reducing the turnaround time (TAT) of laboratory results. Optimization potential within the complete preanalytical process was reviewed to obtain potential improvement measures. These measures fell into two groups: training to reduce preanalytical errors in the entire hospital and using blood collection tubes with lower nominal fill volumes.Results:A validation of the success of these measures was performed after 1 year. The occurrence of several blood collection non-compliances had decreased substantially. By changing the blood collection tube volume, approximately 177 L less patient blood was drawn for diagnostic purposes in the 384-bed hospital per year. For geriatric and intensive care unit (ICU) patients, there was a very significant reduction in diagnostic blood loss (−27.2% ICU, −42.5% geriatric patients). The number of tubes used per patient per day decreased by 13%.Conclusions:In conclusion, this approach represents an important lab-side contribution to PBM concepts.