JULY 2019
ISSUE
Early registration ends
August 2!
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SABM 2019 Newsletter Publication Schedule
March | July | November
Editor: Carolyn Burns, MD
Associate Editor: Tiffany Hall, RN
Sherri Ozawa, RN
Kevin Wright
New Newsletter Team Members
Majed Refaai, MD
Christine Cahill, MS, BSN, RN
Mary Ann O'Brien, RN, MSN, CCRN, CNE
Contributors for This Issue
Ananthi Krishnamoorthy, MD
Robin Ortega, RN
Danielle Dropkin, BS
Allison Jones, PhD, RN
Marketing
Carmen Melseth
SABM Officers and
Directors
© 2019 Society for the Advancement of Blood Management
350 Engle Street Englewood, NJ 07631 USA Phone: (928) 551-6400 Fax: (877) 944-2272 EMAIL: [email protected] |
Featured Affiliates
1. St. Mary's Medical Center and Palm Beach Children's Hospital
2. NYU Langone Health’s Patient Blood Management (PBM) Program
 
St. Mary's Medical Center and Palm Beach Children's Hospital
Contributor: Robin Ortega, RN
St. Mary’s Medical Center, founded in 1938, is a 460-bed acute care hospital located in West Palm Beach, Florida. Palm Beach Children’s Hospital at St. Mary’s Medical Center is a 138-bed pediatric hospital, and member of the Children’s Hospital Association, that provides highly specialized services to more than 50,000 children each year. Our specialties include a state-designated Regional Perinatal Intensive Care Center, Level lll NICU, and a Level 1 trauma center that treats more than 120,000 adult and pediatric patients per year. We also have pediatric and adult intensive care units, pediatric hematology and oncology, a comprehensive stroke center with neuro-interventional imaging technology and the Paley Orthopedic and Spine Institute.
Gabrielle Finley-Hazle was appointed as the hospitals’ CEO in 2016 and brought with her both the desire and experience to develop a blood conservation program. As a result of her evidence-based knowledge that transfusion-free medicine and surgery produces better patient outcomes, she began to reach out to medical and nursing staff to determine if there were sufficient stakeholders to start a PBM program. The hospital staffs also had the support of Dava Grundhoefer, MD, chief of anesthesiology, who champions PBM at St. Mary’s and Palm Beach Children’s Hospital.
In February 2018, the PBM program was founded. That same month, Aryeh Shander, MD presented “Treatment Options for your Patients Requiring Urgent Warfarin Reversal: A Case Based Presentation,” to the nursing staff, and hosted a grand rounds to the medical staff on blood conservation. He also spoke to the Paley Orthopedic and Spine Institute staff at their grand rounds, outlining techniques to treat iron deficiency anemia preoperatively. The Paley team adopted the suggestions immediately and have lowered their use of RBC transfusions by 46% from 2017- 2018.
Since the program’s inception, Dr. Shander has worked as a physician advisor to the medical staff and resource to the PBM steering committee. His wealth of experience and knowledge has inspired many to look beyond the culture of the “easy fix” and realize what is truly in the patients’ best interests to improve their overall outcomes.
Sheldon Lefkowitz, director of pharmacy at St. Mary’s Medical Center and Palm Beach Children’s Hospital, and his team have been leading the way in providing non-blood modalities such as ESA’s, IV iron and tranexamic acid. The hospitals are now implementing a bio-similar ESA, a suggestion at the 2018 SABM annual meeting, and this agent is now available to patients with positive outcomes and decreased cost.
Jay Goodman, director of the laboratory at St. Mary’s Medical Center and Palm Beach Children’s Hospital, and another champion of PBM, has worked diligently to implement the suggestions provided at the 2018 SABM meeting. The hospitals now offer the RetHe test for physicians to determine iron deficiency and iron deficiency anemia, and all laboratory equipment uses the minimal amount of blood for testing. The thromboelastography (TEG) instruments, help all areas of the hospitals, especially the level I trauma center and The Birthplace at St. Mary’s Medical Center, to determine in real-time the most appropriate action to take for patients with active bleeding and/or coagulopathies.
NYU Langone Health’s Patient Blood Management (PBM) Program
Contributor: Danielle Dropkin, BS
While only in our first year, NYU Langone Health’s Patient Blood Management (PBM) program has seen great success in raising awareness amongst clinicians on PBM and the important role it plays in value-based medicine. With our main campus located in the heart of Manhattan, and additional facilities positioned throughout the New York City area, NYU Langone consists of six inpatient locations, three emergency departments, 98 operating rooms, and over 1,500 beds. Patient Blood Management has been a beneficial new program that aligns with all three areas of NYU Langone’s mission: to serve, teach, and discover. Although NYU Langone providers have been practicing and providing services critical to a PBM program for years, the development of a centralized program to provide support, resources, and education was seen as something that was equally important for the health system and our patients.
NYU Langone’s decision to invest in a PBM program came from our PBM lead, Dr. Seth Perelman (Clinical Associate Professor, Department of Anesthesiology, Perioperative Care, and Pain Medicine), who drew inspiration from his past experience at Englewood Hospital. Through a Value-Based Management-focused committee of surgeons, championed by Surgeon-in-Chief, Dr. Paresh C. Shah, PBM was determined to be a strategic priority for the institution, backed by our executive leadership team. NYU Langone has determined that our PBM program will focus on reducing blood utilization and blood variability throughout the system, improving the screening and management of anemia, and developing a comprehensive bloodless medicine and surgery program to ensure a high quality patient experience for all.
Under Dr. Perelman’s leadership and direction, NYU Langone entered into a partnership with SABM prior to the Annual Conference in September 2018. We viewed this as the perfect opportunity to launch our program externally, encourage our core PBM providers to attend and learn from their peers and experts in the field, and, ultimately, disseminate SABM innovations and techniques across our institution. Our hospital affiliation with SABM and our attendance at the annual conference kicked our PBM program into high gear and generated interest throughout the health system. Thanks to the SABM conference, several of our physicians were able to complete the PBM Certificate course and had a platform to share their PBM-related research. Becoming part of this growing community at such an early stage of our program’s development helped bolster the program’s strength and direction at NYU Langone.
As we continue to expand the program, we’re looking to use what we learned from the SABM conference to continue to provide best in class techniques for our patients. Examples of this include continuing partnering with our Epic team to optimize our PBM protocols and make data easily accessible and actionable through dashboards. We’re working hard to add more participating physicians to our bloodless surgery referral list, as well as continuing an educational roadshow to help physicians and staff stay abreast of best practices, both clinical and administrative. Lastly, Drs. Jeanna Blitz and Christian Mabry (also within the Department of Anesthesiology) have been piloting our virtual pre-op anemia clinic, providing an extremely valuable service to both our patients and physicians in streamlining the screening, diagnosis, and management of anemia. The culmination of the past year’s efforts and leadership’s dedication to the program is shown through a recent approval to hire full-time staff and dedicated PBM team.
SABM has been an extremely valuable partner in more ways than one; we were excited and honored to be able to work with this exciting organization and hope to continue to do so as our program grows in the future.
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Consider submitting your future manuscripts in PBM for peer review and publication in this new section. The success of this endeavor will depend on the provision of material to make it lively and attractive to our colleagues and other professionals in the field.
Members Invited to Submit Papers CLICK HERE
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