ABSTRACT
Blood management is a concept that adopts a principle of improving patient outcome by integrating all available techniques to ensure safety, availability, and appropriate allocation of blood products. This constitutes a model of multidisciplinary care where the changes in culture are system directed on the basis of evidence-based medicine. There are about 14% US hospitals where any kind of blood management program exists, although the idea remains the same but the programs vary in their execution, implementation, and ultimately providing the value to patients. In this article, we have described our experience of creating a patient-centric, cost-effective, evidence-based, and multipronged program creation with scalable results. The use of data, education, process improvement, engagement, and accountability of caregivers have resulted in sustained results and helped in creating a comprehensive blood management program.
Subject(s)
Blood Specimen Collection/methods , Blood Transfusion , Hospital Administration/methods , Quality Improvement/organization & administration , Blood Specimen Collection/economics , Clinical Protocols , Cost-Benefit Analysis , Hospital Administration/economics , Humans , Inservice Training , Patient-Centered Care/organization & administration , Practice Guidelines as Topic , Quality Improvement/economicsABSTRACT
BACKGROUND: The Advisory Committee on Immunization Practices and the Healthcare Infection Control Practices Advisory Committee recommend health care personnel (HCP) influenza vaccination to prevent transmission to patients. Recommendations include documenting declination and providing feedback of rates. We report the use of the intranet to achieve recommendations with mandatory participation of 20,170 HCP in an 1100-bed hospital. METHODS: Employees were required to log onto the intranet and select "vaccine received," "contraindicated," or "declined." Declining employees automatically received a screen with education about vaccination. A Microsoft Structured Query Language database was created and linked to a Human Resource database. Administrators were provided feedback on participation rates. Employees were notified of the program via letter. Reminders were provided through managers and newsletters. RESULTS: Eighty-nine percent (17,998/20,170) accessed the intranet. Fifty-five percent (11,068) indicated "vaccine received" versus 38% in 2004-2005 (P < .000001), 31% (6300) "declined," and 3% (630) had "contraindications." Unit rates ranged from 24% to 91%. CONCLUSION: The intranet provides a tool for measuring and reporting participation, declination, and vaccination rates. The intranet and a mandatory participation program were associated with an increase in rates. Low rates in HCP with access to, and education about, vaccine may impact consideration of a mandatory vaccination program.
