SUMMER 2017
ISSUE
The Society for the Advancement of Blood Management (SABM)
invites healthcare organizations worldwide to participate in this week dedicated to educating patients and healthcare professionals about patient blood management.
Download SABM's
Patient Blood Management Awareness Week 2017
Poster and Timeline
Please consider making a donation to your Society. Your donations will help us to improve the lives of people throughout the world through Patient Blood Management.
SABM 2017 Newsletter Publication Schedule
February | May | August | November
Editor
Carolyn Burns, MD
Associate Editor
Tiffany Hall, RN
Contributors
Carolyn Burns, MD
Nabil Hassan, MD
Tiffany Hall, RN
Mary Ann O’Brien RN, MSN, CCRN, CNE
Becky Rock, RN
Kevin Wright
Zac Zahara, MBA and team
Transition Director
Sherri Ozawa, RN
SABM Officers and
Directors
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Featured Affiliate
The Advanced Bloodless Program (ABP) opened at Providence Seattle Medical Center (PSMC) in January 1999, just a few blocks east of Swedish Medical Center. At the time, PSMC was a 190-bed facility that provided a full line of hospital specialties including cardiac surgery, orthopedic surgery, and obstetrical care. The ABP was developed at the request of Kimble Jett, MD, a cardiac surgeon at PSMC who, in 1998, had recently moved to Seattle from a Texas hospital that has a bloodless program. Since no one at PSMC had ever heard of bloodless programs and had no idea how to set up such a program, a search was conducted for consultants to help develop the program. The search found several resources, one of which was Bernice Goldstein who had a very successful program in the Tri-cities area in Washington State. Bernice was offered the job of setting up and managing what became known as the Advanced Bloodless Program.
Like many PBM programs, the ABP started life as a bloodless program, a program to meet the needs of patients who absolutely refuse blood transfusions such as Jehovah’s Witnesses. Many novel and innovative blood sparing and maximization technologies and strategies had been developed in the decades following the HIV/AIDS epidemic of the 1980s, and these fit nicely as adjuncts to traditional care to offset refusal of transfusion. As a result, the 1990s saw a boom in the development of bloodless programs. The ABP at PSMC served as a bridge to connect providers, patients, and emerging technology to eliminate the use of blood and optimize outcomes for this select patient population.
Over time, it became clear that many, if not most, patients did not want blood transfusions even though they did not absolutely refuse transfusions. These patients asked to take advantage of the ABP strategies and technologies to avoid blood transfusion. Since these patients didn’t fit the ABP criteria (absolute refusal), is was clear there needed to be another program for these patients. That’s how Blood Conservation started at Swedish.
Swedish Medical Center (SMC) bought PSMC in 2000 about the same time the Blood Conservation program was drafted. From the beginning, even as the policy, procedures, resources, and identifiers were created for the program, it was obvious that Blood Conservation was a high quality, evidence-based, patient-centered standard of care that should be offered to all patients. Over the course of the next seven years, what was once novel, cutting-edge technology at the heart of blood conservation such as minimal laboratory sampling and pre-surgical anemia management became the norm. We no longer needed a separate program to provide blood conservation for all patients. We reached our goal.
Swedish Blood Management work certainly did not end in 2008. Beginning in 2012, our program began to bring transfusion services in-house (as we were previously part of a centralized transfusion model). At this time we decided to staff our blood management team with nurses and medical technologists so we could act as the bridge between the transfusion service and nursing/providers. We also revamped our Epic blood orders, combining what was once multiple orders and steps into one simple order set. This order set helps guide transfusion practice by ordering only when needed and making it a process to transfuse one unit at a time.
Our current work is concentrated on finding the best approach to providing 100% transfusion review with real-time and/or shortened lag time feedback; modifying Epic to assist our caregivers through the transfusion process; simplifying pre-op anemia management utilizing our pre-operative clinics; and nursing education. We have aligned our program with the AABB Blood Management guidelines as well, but have not sought accreditation as the Swedish system is DNV accredited, not Joint Commission.
Looking to the future, Blood Management and Bloodless Medicine still present many challenges. Blood utilization and transfusion appropriateness require increasingly more resources as medicine advances into transplant and cell therapy arenas. Research for blood substitutes continues and Swedish participates in studies to evaluate the safety and efficacy of these products. Yes, there are many goals still to reach.
Contributors:
Harriette Lober - Bloodless Program Specialist
Dawn Peterson, RN BSN - Blood Management Specialist
Jeannette Batt, RN BSN - Blood Management Specialist
Andrea Nordmark, MT (ASCP) - Blood Management Specialist
Zac Zahara, MBA - Administrative Director System Lab and Blood Services
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PBM for Patient Blood Management Section
Save the Date for SABM's Annual Meeting
September 7 – 9, 2017
Hilton & Executive Tower
Portland, Oregon
PBM Certificate Course
September 6, 2017
7:00am – 6:00pm
Annual Meeting
September 7 – 9, 2017
Join SABM's Call to Action for Medicare to Expand Coverage for Treatment of Anemia!
Click HERE for detailed information about what you can do to get involved.
© 2017 Society for the Advancement of Blood Management
350 Engle Street
Englewood, NJ 07631
Phone: (928) 551-6400
Fax: (877) 944-2272
EMAIL: [email protected]
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