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

Gallagher, Trudi; Leahy, Michael F.; Darby, S.; Campbell, Linda A.; Howman, Rebecca; Watts, Sarah; Vodanovich, M.; Tovey, Julie; Esson, Anne; Koay, Audrey

doi:10.1111/voxs.12350

Cited by 7 publications

(14 citation statements)

References 12 publications

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“…The authors are aware that health service human and financial resources are limited; from their experience, any process developed to support PBM must be sustainable and suggest that processes are included within existing workflows, and importantly, these processes should not rely on specific individuals but more on a robust process that can be applied by anyone fulfilling the role for a greater chance of success. This is reinforced by Gallagher et al (2017).…”

Section: Preoperative Anaemia Clinics/assessment Pathwaysmentioning

confidence: 89%

“…As PBM is becoming more established, there is an increasing number of peer‐reviewed literature becoming available about the TP and their role in PBM (Puca & Johnson, , Miller et al, , Freedman, , Moss, , Gallagher et al .·). As Freedman also acknowledged, it is important for those in the role to document and share their experiences, challenges and successes to allow others to learn from these.…”

Section: Transfusion Practitionersmentioning

confidence: 99%

“…Red cell use was reported to reduce by 41% during the study period, reporting a cost saving of $AUD18·5 million (Gallagher et al, , Leahy et al, , ). It must also be noted that, nationally, in Australia, red cell use was also declining at the rate of 21% from 2011 to 2016; although many factors may have influenced this decline, the NBA annual report attributes the reduction to the ongoing success of programmes to improve appropriate use and also those to reduce waste (National Blood Authority, ).…”

Section: Pbm Strategies and The Role Of The Transfusion Practitionermentioning

confidence: 99%

“…The TP is recognised as a key member and resource within these multidisciplinary teams (Bielby et al, 2018a). AuBuchon et al (2011) and Gallagher et al (2017) both reinforce PBM as a programme for patients delivered by a multidisciplinary team of healthcare professionals within an organisation -medical, nursing, laboratory and pharmacy staff and also including external providers such as the patient's primary care physicians (general practitioners). One characteristic critical to all PBM programmes is the 'buy in' from all involved across the clinical spectrum.…”

Section: Transfusion Practitioners and Pbmmentioning

confidence: 99%

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Patient blood management and the importance of the Transfusion Practitioner role to embed this into practice

Bielby

Moss

2018

Transfusion Medicine

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Patient blood management (PBM) is a widely established international initiative, with a multidisciplinary approach to reduce transfusion. The Transfusion Practitioner (TP) role is well embedded in the United Kingdom (UK) and Australia. The value of the TP in changing both culture and practice to implement an all-inclusive PBM approach to care will be discussed. The TP role was born from both a safety and haemovigilance culture, where the greatest identified risk to the patient undergoing a transfusion was human error. From this initial trigger for improved safety, the TP role has evolved to a multifaceted, highly specialised role, involved in both PBM and transfusion processes. As the transfusion paradigm shifted from product to patient, the TP role evolved to include PBM, with an emphasis on the patients and the impact transfusion has on them. A multidisciplinary team is required to drive both PBM and transfusion; the TP is recognised as a critical link in the multidisciplinary team. They are seen as a driving force for change, bridging the gap between the laboratory and clinical arenas. The TP plays a vital role in helping establish and embed PBM that improves patient and safety outcomes.

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Section: Preoperative Anaemia Clinics/assessment Pathwaysmentioning

confidence: 89%

Section: Transfusion Practitionersmentioning

confidence: 99%

Section: Pbm Strategies and The Role Of The Transfusion Practitionermentioning

confidence: 99%

Section: Transfusion Practitioners and Pbmmentioning

confidence: 99%

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Patient blood management and the importance of the Transfusion Practitioner role to embed this into practice

Bielby

Moss

2018

Transfusion Medicine

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“…Interventions to support the implementation strategies included distributing information (e.g. pamphlets) [16,22], setting up online learning portals [16], holding educational sessions at grand rounds [11], and implementation of performance tracking dashboards [45,46]. ERIC strategies that were not used to address this barrier included identifying local barriers, conducting a needs assessment and informing local opinion leaders.…”

Section: Alter Incentive/allowance Structures Conduct a Local Needs Amentioning

confidence: 99%

Overcoming barriers to evidence-based patient blood management: a restricted review

et al. 2020

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Background: Blood transfusions are associated with a range of adverse patient outcomes, including coagulopathy, immunomodulation and haemolysis, which increase the risk of morbidity and mortality. Consideration of these risks and potential benefits are necessary when deciding to transfuse. Patient blood management (PBM) guidelines exist to assist in clinical decision-making, but they are underutilised. Exploration of barriers to the implementation and utilisation of the PBM guidelines is required. This study aimed to identify common barriers and implementation strategies used to implement PBM guidelines, with a comparison against current expert opinion. Methods: A restricted review approach was used to identify the barriers to PBM guideline implementation as reported by health professionals and to review which implementation strategies have been used. Searches were undertaken in MEDLINE/PubMed, CINAHL, Embase, Scopus and the Cochrane library. The Consolidated Framework for Implementation Research (CFIR) was used to code barriers. The Expert Recommendations for Implementing Change (ERIC) tool was used to code implementation strategies, and subsequently, develop recommendations based on expert opinion. Results: We identified 14 studies suitable for inclusion. There was a cluster of barriers commonly reported: access to knowledge and information (n = 7), knowledge and beliefs about the intervention ( = 7) and tension for change (n = 6). Implementation strategies used varied widely (n = 25). Only one study reported the use of an implementation theory, model or framework. Most studies (n = 11) had at least 50% agreement with the ERIC recommendations. Conclusions: There are common barriers experienced by health professionals when trying to implement PBM guidelines. There is currently no conclusive evidence to suggest which implementation strategies are most effective. Further research using validated implementation approaches and improved reporting is required.

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The role of the transfusion practitioner in the multidisciplinary team

Bielby

Haberfield

Kelsey

et al. 2018

ISBT Science Series

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Background Transfusion and patient blood management (PBM) processes are complex; while transfusions can be life‐saving, equally there may be associated morbidity and mortality. In Australia, obligations to comply with mandatory governance frameworks have propelled the safety and PBM culture. These frameworks support appropriate product use and levels of safety at all points of the process. Methods A key to blood management governance success is the multidisciplinary Blood Management team/Governance Committee. This team includes healthcare executive, clinical governance, consumer/s and medical/laboratory/nursing representatives, with the transfusion practitioner (TP) as a key resource. The TP is often seen as the driving force for change, working in a multidisciplinary capacity across the clinical spectrum. In Australia, this influence can be within an individual organization, across multiple sites/networks, in metropolitan or rural/regional areas. The TP conducts a critical role pulling together resources, promoting exchange of information, encouraging engagement and empowering colleagues to facilitate change. Highly developed communication skills assist the TP to engage these many different stakeholders and clinical environments. Collaboration is essential for the multidisciplinary team to function effectively. Highly functional teams recognize knowledge and experience and utilize each member's skills to work together to deliver the best possible outcome for patients. There is a growing body of literature supporting multidisciplinary teams and the TP role improving patient outcomes. Conclusion Effective transfusion and PBM practice require a systematic cross‐specialty approach to ensure success. TPs are an essential link in the multidisciplinary chain and require strong support and leadership to potently effect change and enhance practice.

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

Cited by 7 publications

References 12 publications

Patient blood management and the importance of the Transfusion Practitioner role to embed this into practice

Patient blood management and the importance of the Transfusion Practitioner role to embed this into practice

Overcoming barriers to evidence-based patient blood management: a restricted review

The role of the transfusion practitioner in the multidisciplinary team

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