Premier: Analytics Helping Hospitals Optimize Blood Use

An analysis of 645 hospitals revealed that comparative data analytics to drive performance improvement has the potential to optimize blood use across numerous diagnoses.

The nationwide analysis of 645 hospitals found a 20 percent decrease in blood utilization across 134 diagnoses that account for 80 percent of red blood cell use, according to Premier Inc. Premier, a Charlotte, N.C.-based healthcare improvement company, conducted the analysis using inpatient data on more than 27 million discharges from 2011 through the first half of 2016. Significant decreases in blood use were a direct result of provider efforts to optimize care by improving stewardship of this costly commodity through the use of evidence-based practices around blood use.

Premier officials noted that blood transfusions can cost upwards of $1,000 per unit when accounting for all direct and indirect costs. When used unnecessarily, blood transfusions can also diminish quality of care, increasing the likelihood of allergic reactions, fever, lung injury, immune suppression, iron overload and other adverse events. Transfusions have also been linked to increased risk of morbidity and mortality, as one study found blood transfusions were associated with a 66 percent increased risk of mortality when accounting for comorbidities and other factors during cardiac surgery.

As such, using cost and quality data analytics, Premier produces regular optimization reports that aim to help providers spot cost and quality variations in blood use, as well as the sources or departments that are contributing to the problem, so that leaders can target efforts designed improve the overall cost and quality of patient care.

These reports have aided Premier members in achieving dramatic reductions in overall blood use. Specifically, Premier’s recent analysis documented the following improvements since its 2012 analysis.

• Blood use cut nearly in half across the 10 procedures that use the most blood: When isolating the top 10 procedures that account for the most use in blood, the data highlights a significant 40 percent decline in patients who received blood during this period.
• Orthopedic procedures show steepest declines: Most notably, orthopedic surgeries experienced a steady drop in transfusions recorded over a nearly six-year period. When looking at major joint replacements, nearly 75 percent fewer cases recorded a blood transfusion. Additionally, nearly 30 percent fewer patients undergoing hip and femur surgeries received a blood transfusion.
• No compromise in quality of care: When compared with quality data, trends suggest that reduced blood utilization didn’t negatively impact patient outcomes—as rates of mortality, complications and readmissions also fell.

“Today’s healthcare providers face constant pressures to improve quality and reduce total costs. Given this reality, more providers are looking to optimize blood use, a very expensive resource that can lead to adverse events if not properly managed,” Leigh Anderson, Premier’s chief information officer, said in a statement that accompanied the analysis. “However, managing blood use can be a challenge without strong data and analytics to measure total utilization rates, compare against peer benchmarks and spot areas for improvement.”