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January 17, 2017

How UCLA Health reduced blood transfusions by 18 percent

Daily Briefing

    Switching to all-electronic barcode scanning for the blood administration process helped UCLA Health improve patient safety while using blood more efficiently, according to staff at the health system, John Andrews writes for Healthcare IT News.

    UCLA Health, like many other hospitals that are implementing integrated EHRs, was using a hybrid electronic/paper format to track and administer blood transfusions, explained nursing informaticist Meg Furukawa. But that method can run into interoperability issues. "The biggest drawback is ensuring that the various systems 'talk' to each other," Furukawa said.

    According to Furukawa, switching to the all-electric format "increase[s] patient safety and decrease[s] errors because the patient and the unit of blood are positively identified as well as matched against the provider's transfusion order."

    UCLA project

    The UCLA all-electric initiative was split into two separate projects: transitioning to an all-electronic barcoding system, and then embedding clinical decision support (CDS) for providers ordering blood transfusions. The initiative took about 16 months, and it's been paying dividends, Furukawa said.

    "When ordering, the clinician is presented with the patient's hemoglobin level as well as the information for when blood should be ordered," she explained. This information helps clinicians order the transfusions according to national guidelines.

    Get the playbook for implementing clinical decision support

    Since the clinical support decision system went live, UCLA has decreased its red blood cell transfusion orders by 18 percent—and a lower rate of red blood cell transfusions means a lower risk for patients. "Blood is given everywhere in our hospitals, so we needed to make sure we involved staff from all areas and ensure that the new functionality met everyone's needs," Furukawa said (Andrews, Healthcare IT News, 1/11).

    Well-built alerts make all the difference

    Blood transfusion appropriateness is a well-known and well-studied example of eliminating unnecessary care, and UCLA Health is one of several organizations that have built clinical decision support to prompt adherence to Choosing Wisely guidelines.

    Advisory Board has found in our evidence-based guidance consulting work that well-built alerts make all the difference—and can yield major gains, often as little as 12 weeks after implementation. For instance, one health system that partnered with us achieved a 32 percent decrease in inappropriate ordering using new blood transfusion content.

    To learn more about our Evidence-Based Guidance support, fill out this two-minute form, and one of our experts will get in touch with you shortly.

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