Establishing a culture of blood management through education: A quality initiative study of postoperative blood use in CABG patients at methodist debakey heart & Vascular Center

Blood management strategies are crucial in light of transfusion-related health risks to patients and the relative scarcity and cost of blood products. The authors describe a collaborative quality initiative to reduce blood use in their coronary artery bypass graft (CABG) population and other cardiovascular intensive care unit (CVICU) patients. A multidisciplinary team was engaged at all levels of patient care. The 2-part initiative involved a direct educational component emphasizing transfusion risk awareness and patient-centered blood management strategies accompanied by a data-based component that included monthly dissemination of blood product use to the relevant service lines. The authors observed a reduction in postoperative blood product use among CABG patients (14.3% decrease in the first year; 30.6% from 2006 to 2008) and an 18.2% reduction in blood product volume used in the entire CVICU, with no additional harm to patients and a trend toward better outcomes. This team-driven paradigm change has made blood management everyone's initiative.