Smart blood use receives an extra shot of innovation

blood donations while passing time with handheld electronic deviceTwo years ago, Carle pathologist Bruce Wellman, MD, saw the amount of blood transfused at Carle Foundation Hospital trending upward while national use of red cell units trended downward.

Carle, he felt, had an opportunity to change with the patient's safety in mind.

Blood transfusion is safe from an infectious disease standpoint. Yet, other effects exist, meaning transfusion should only occur when doctors see clear benefits.

With physician leaders and staff from Carle Blood Bank, Dr. Wellman began researching this topic. They reviewed increased blood use, best practices and patterns of use.

Even when barriers to change appeared, one thought powered this group through.

“Our doctors and nurses, along with all staff, do the right thing when presented with the right information,” Dr. Wellman said.

Research efforts led Carle to a new standard for transfusing blood. These changes helped produce the following results:

  • Carle uses about 700 units of blood and blood products per month now, a big drop from two years ago.
  • A 30 percent cut in blood-part use in about 18 months.

Carle doctors grasped what the analysis meant and changed their ways.

At the same time, nurses gained confidence in alternatives to blood transfusion. Blood Bank staff reviewed requests and educated ordering providers on the go.

One outcome rose above all others.

“More than 6,000 fewer transfusion events over two years in a system of this size is a major improvement in patient safety,” Dr. Wellman said. “Now there are fewer ways to complicate treatment, which means Carle patients are the real winners.”

Over the last couple of years, though, he noticed another trend. As the medical director for Champaign-Urbana’s blood bank, Dr. Wellman watched the country's number of donors drop.

He hopes people don’t think less blood used means less need for donations.

In fact, the opposite is true.

“Red cell use across the country has dropped from 12 million to 9 million per year, but the donor base has also gotten smaller,” Dr. Wellman said.

“So we still need people to show up all the time to donate, not just when some event gathers national attention.”

Last month, the American Association of Blood Banks (AABB), America’s Blood Centers and the American Red Cross issued an urgent appeal to blood and platelet donors across the United States.

“Maintaining a safe and adequate blood supply is critical to the nation’s public health and a priority for the medical community. It is indispensable and required in the treatment of millions of patients, including individuals with cancer and other life-threatening diseases, patients undergoing organ transplants and trauma victims,” said Miriam A. Markowitz, CEO of AABB.

Dr. Wellman hopes people keep blood donation top of mind at all times.

“Constant, repeated, regular donation of blood is a much better way to have blood available when it’s needed,” he said.

And with the blood on hand, physicians across Carle remain dedicated to using it the best ways possible for patients.