Analysis of a 5-year, evidenced-based, rational blood utilisation project in a South African regional hospital.

BACKGROUND: Blood products are a lifesaving but limited resource, particularly in resource-limited settings. Evidence-based transfusion criteria tailored to local hospitals have shown great promise in reducing costs, minimising shortages, and ameliorating the morbidity and mortality associated with liberal blood product usage. We implemented the "Saving Blood, Saving Lives" project to: promote responsible blood product use and reduce blood product ordering inefficiencies and expenditure. METHODS: A comprehensive change management programme, preceded by 3 months of clinical department consultation and training, was implemented. A new evidence-based protocol for blood product utilisation was developed, together with an accountability form. This form was used in monthly audit meetings to refine policies, identify new problems, improve communication, and to drive hospital staff accountability and training. The primary measure of the programme's success was the change in the number of red cell concentrate units ordered. RESULTS: Project implementation required minimal time and no additional budget or staff. Annual red cell concentrate usage reduced from 7211 units in year one to 4077 units in year 5 (p < 0.001). Similar reductions were seen in freeze-dried plasma and platelet usage, as well as administrative costs. Total project saving, adjusted to baseline admission numbers, amounted to over R46 million ($2.5 million). CONCLUSIONS: As a change management programme centred the "Saving Blood, Saving Lives" project, was able to significantly reduce blood product-related administration and expenditure by implementing evidence-based transfusion criteria. The programme is simple, replicable and cost effective, making it ideally suited for use in resource-constrained environments.

Stakeholder relations in Australian science journalism.

This study explores the relationships between scientists, science communicators and science journalists in Australia. Building upon a smaller previous study, this article provides an overview of the science media landscape across a nation through the use of semi-structured interviews with members of stakeholder groups. Although relationships between each of the groups are generally positive, a lack of clear understanding of the professional practice and cultures of the different groups sometimes appear to hinder positive interactions. Many scientists continue to lament the need for journalists to understand more science, yet very few make similar comments about the need for scientists to know more about media. Refocusing on sharing the responsibility for science reporting may be a means of bridging the identified cultural divide.