(P-PB-17) Using Blood Wisely: A National Campaign To Engage Hospitals In Appropriate RBC Transfusion Practice

Background/Case Studies: In September 2020, a national campaign called “Using Blood Wisely” was launched. The aim was to engage hospitals nationally to audit their red blood cell (RBC) use and participate in an effort to decrease inappropriate use.

Study

Design/Methods: Using Blood Wisely met with stakeholders to develop a national benchmark for appropriate transfusion, a measurement strategy, effective change interventions based on the best available evidence and a mechanism to recognize success. Resources to support implementation included: educational videos; a planning survey; templates for guidelines, order sets, and transfusion order screening standard operating procedures; and a webinar series. Benchmarks were defined as having at least 65% of RBC transfusion episodes as single unit transfusions and at least 80% of RBC transfusions with a pre-transfusion hemoglobin 8 g/dL or less. Engagement in the initiative was measured by the number of organizations signing up to participate, entering audits, meeting benchmarks, and being designated as a Using Blood Wisely hospital when benchmarks were sustained for four months. Secondary outcomes were the types of interventions employed by designated organizations.

Results/Findings: Nationally, 659 hospital sites receive blood for transfusion. Up to Dec 31, 2022, 169 organizations (239 hospital sites) signed up to participate in Using Blood Wisely; 154 organizations (91%) submitted a baseline audit: 98 (58%) met the single unit transfusion benchmark; 112 (66%) met the pre-transfusion hemoglobin benchmark; and 81 (48%) met both benchmarks (Figure A). After sustaining the benchmarks for at least 4 months, 68 organizations received the Using Blood Wisely designation; of these, 15 (22%) had not met the benchmarks at baseline. Designated organizations employed the following interventions: guidelines (82%), education (74%), transfusion order screening (66%), order sets (65%), audit and feedback (62%) and alternatives to blood initiatives (34%).

Conclusions: Using Blood Wisely was successful in engaging hospitals to participate in a national campaign to measure appropriate RBC transfusion practice and be recognized for their efforts. Although most designated organizations met the benchmarks at baseline, 22% achieved the benchmark during the campaign. The next phase of the initiative will focus on understanding if there are key interventions necessary for success and supporting hospitals who are actively entering audit data but have not yet met the benchmarks.

Importance of research: Using Blood Wisely is a national campaign to promote appropriate red blood cell transfusion use. This novel initiative has demonstrated broad engagement, the ability to benchmark multiple organizations in order to identify opportunities for improvement and established a mechanism to recognize organizations for their success.