Patient Blood Management
June 8, 2011
AABB commends the committee for considering the important topic of patient blood management (PBM). For over 60 years, AABB has been dedicated to improving blood safety and care for patients receiving transfusions. This goal has included the appropriate use of blood components and derivatives, the use of techniques and procedures that help reduce the need for blood transfusion, and careful consideration of ways to avoid blood transfusion.
With PBM, as with other blood safety issues, AABB’s focus is on the patient. Thus, AABB embraces the term “patient blood management.” PBM encompasses all aspects of patient evaluation and clinical management surrounding the transfusion decision-making process, beginning with preoperative evaluation of patients and continuing through the intra- and postoperative period of the patient's hospital stay. A comprehensive PBM program includes the application of appropriate indications, as well as minimization of blood loss and maximization of patient red cell mass. PBM must be evidence-based and demonstrated to improve patient outcomes.
In order to be effective, PBM must be a multi-disciplinary process involving transfusion service and laboratory medical directors, providers of perioperative autologous blood services, nurses, anaesthesiologists, surgeons, and providers in other clinical specialties who care for patients who may need transfusion of blood components. Ideally, hospital clinical, operational and administrative leaders as well as blood center representatives will be involved in establishing PBM programs.
AABB is a leading organization in educating health-care professionals about PBM and blood utilization review. The association offers many resources that address the various aspects of PBM, helping members achieve their goals of avoiding unnecessary transfusion and conserving blood usage, following evidence-based ordering and administering practices to optimize patient outcomes, and auditing physician compliance with established criteria for transfusion. AABB has set standards for blood banks and transfusion services for over 50 years and for perioperative autologous blood collection and administration for over 30 years. AABB’s PBM-related educational materials and programs include a variety of publications and guidance documents, numerous sessions at our Annual Meetings, and audioconferences.
In addition, AABB is developing a number of programs for hospitals needing assistance and guidance on implementation of a comprehensive PBM program. These programs will outline best practices and useful approaches as well as stepwise directions to performing procedures to optimize PBM.
Finally, in an effort to advance evidence-based PBM and patient care, AABB is actively developing clinical practice guidelines for appropriate indications for Red Blood Cells. These valuable practice guidelines are being produced by a group of expert AABB members, along with essential input from representatives of key clinical specialties (including trauma physicians, anesthesiologists, cardiologists, hematologists, and pediatricians). This resource is scheduled to be available by the end of 2011.
AABB welcomes the opportunity to continue working with all interested parties on advancing PBM as a means of improving patient care.