Transfusion therapy: improved patient care and resource utilization.

Improving the quality of medical care while reducing costs is one of the major challenges facing the health care system in the United States. At a 1020-bed, tertiary-care, teaching hospital, the Transfusion Committee modified transfusion practice by establishing new transfusion guidelines based upon national standards rather than local practices and by implementing educational and monitoring systems. Over a 3-year period, the number of transfusions decreased, the types of transfused components changed, and the waste due to unused components decreased. From the baseline of Fiscal Year (FY) 1989 (89), the number of exposures to components from allogeneic blood donors for the patient population decreased by 11,015 in FY 90, 14,067 in FY 91, and 16,990 in FY 92, thereby decreasing the risk of transfusion-transmitted disease, transfusion reaction, and alloimmunization. As compared to costs in FY 89, the altered transfusion practices resulted in cost savings of $376,269 in FY 90, $566,375 in FY 91, and $684,704 in FY 92. Over the 3-year period, exposures to components from allogeneic blood donors for the patient population were reduced by 42,072, and the total cost savings was $1,627,348. The methodology and results should be reproducible at other hospitals.