EHR allows for reduction in blood transfusions

A Minnesota hospital has cut the average amount of blood transfused by 14 percent since 2011 using a decision support tool in its EHR.

The pathology department of Regions Hospital in St. Paul developed the tool, which is designed to improve the appropriate use of red blood cells based on the latest evidence-based clinical guidelines.

“We are successfully changing the thinking behind transfusions,” said Amar Subramanian, MD, an informatics pathologist at Regions Hospital. “A blood transfusion is like a liquid transplant, and even under ideal conditions, it’s not as good as someone’s own blood.”

As part of this work, Regions Hospital reduced the point at which doctors initiate a transfusion, called the hemoglobin trigger, to less than 7 g/dl in stable patients. The decision support tool automatically alerts physicians if a patient’s most recent hemoglobin levels are above that and also cautions against administering more than one unit of blood at a time.

Premier healthcare alliance issued a report last year analyzing blood use at 464 hospitals and determined that if all hospitals adopted these evidence-based best practices, it would result in saving more than 802,000 units of blood and $165 million without a decline in patient outcomes.