Anaesthesia Department, Hospital del Mar Medical Research Institute, IMIM, Barcelona, Spain.
Perioperative Medicine Research Group, Hospital del Mar Medical Research Institute, IMIM, Barcelona, Spain.
Blood Transfus. 2021 May;19(3):205-215. doi: 10.2450/2020.0105-20. Epub 2020 Sep 18.
Patient blood management (PBM) is an evidence-based care bundle with proven ability to improve patients' outcomes by managing and preserving the patient's own blood. Since 2010, the World Health Organisation has urged member states to implement PBM. However, there has been limited progress in developing PBM programmes in hospitals due to the implicit challenges of implementing them. To address these challenges, we developed a Maturity Assessment Model (MAPBM) to assist healthcare organisations to measure, benchmark, assess in PBM, and communicate the results of their PBM programmes. We describe the MAPBM model, its benchmarking programme, and the feasibility of implementing it nationwide in Spain.
The MAPBM considers the three dimensions of a transformation effort (structure, process and outcomes) and grades these within a maturity scale matrix. Each dimension includes the various drivers of a PBM programme, and their corresponding measures and key performance indicators. The structure measures are qualitative, and obtained using a survey and structured self-assessment checklist. The key performance indicators for process and outcomes are quantitative, and based on clinical data from the hospitals' electronic medical records. Key performance indicators for process address major clinical recommendations in each PBM pillar, and are applied to six common procedures characterised by significant blood loss.
In its first 5 years, the MAPBM was deployed in 59 hospitals and used to analyse 181,826 hospital episodes, which proves the feasibility of implementing a sustainable model to measure and compare PBM clinical practice and outcomes across hospitals in Spain.
The MAPBM initiative aims to become a useful tool for healthcare organisations to implement PBM programmes and improve patients' safety and outcomes.
患者血液管理(PBM)是一种基于证据的护理措施,通过管理和保存患者自身血液,已被证明能够改善患者的结局。自 2010 年以来,世界卫生组织已敦促会员国实施 PBM。然而,由于实施 PBM 隐含的挑战,医院在开发 PBM 项目方面进展有限。为了解决这些挑战,我们开发了一个成熟度评估模型(MAPBM),以帮助医疗保健组织衡量、基准测试、评估 PBM,并交流其 PBM 计划的结果。我们描述了 MAPBM 模型、其基准测试计划以及在西班牙全国范围内实施该模型的可行性。
MAPBM 考虑了转型努力的三个维度(结构、过程和结果),并在成熟度量表矩阵中对这些维度进行分级。每个维度都包括 PBM 计划的各个驱动因素,以及它们相应的措施和关键绩效指标。结构措施是定性的,通过调查和结构化自我评估检查表获得。过程和结果的关键绩效指标是定量的,基于医院电子病历中的临床数据。过程的关键绩效指标针对每个 PBM 支柱中的主要临床建议,并应用于六个常见的失血量大的程序。
在最初的 5 年里,MAPBM 在 59 家医院中部署,并用于分析 181826 例医院病例,证明了在西班牙实施一种可持续的模型来衡量和比较医院之间的 PBM 临床实践和结果的可行性。
MAPBM 计划旨在成为医疗保健组织实施 PBM 计划和改善患者安全和结局的有用工具。