The next chapter in patient blood management: real-time clinical decision support.

摘要: Objectives: Blood transfusion was identified by the American Medical Association as one of top five most frequently overused therapies. Utilization review has been required accreditation agencies, but retrospective ineffective due to labor-intense resources applied only a sampling events. Electronic medical records have allowed clinical decision support (CDS) occur via best practices alert at critical point concurrently with physician order entry. Methods: We emerging strategies for improving blood utilization. Results: Implementation CDS our institution decreased percentage transfusions in patients hemoglobin level more than 8 g/dL from 60% less 30%. Annual RBC were reduced 24%, despite concurrent increases patient discharge volumes and case mix complexity. This resulted acquisition costs savings (direct product purchase costs) $6.4 million over 4 years. Conclusions: able significantly reduce inappropriate related through an educational initiative coupled real-time CDS. In deriving increased value out health care, can be number overuse measures laboratory testing, radiology, therapy such antibiotics, outlined Board Internal Medicine’s Choosing Wisely campaign.