Effects of a CME program on physicians' transfusion practices.

A two-stage project was designed to assess physicians' transfusion practices and to evaluate the effectiveness of a continuing medical education (CME) lecture to change these practices. The hospital charts of 44 patients who were autologous blood donors undergoing elective orthopedic surgery and a matched group of 44 patients who were not autologous blood donors were analyzed to determine their physicians' transfusion practices. The groups were matched for age and sex distribution and for procedure. The results suggested that the physicians accepted lower hematocrit levels for autologous-donor patients, did not request adequate amounts of autologous blood, overtransfused some patients with their own blood, and did not schedule the elective procedures far enough in advance to allow patients to deposit the requested amounts of autologous blood. A CME program developed to address the latter three problems was given to seven subspecialty groups in a grand rounds lecture format. Follow-up comparisons of the orthopedic surgeons' blood transfusion practices indicate that after the CME program they did significantly less underordering of autologous blood but still did not increase the time for patients to donate the requested amounts of blood.