Trimming Transfusions by Half

UC San Diego reduces unnecessary blood transfusions with Epic


Because of the high risk and cost associated with blood transfusions, a multidisciplinary team at University of California San Diego Health questioned whether each unit of red blood cells patients received was medically necessary. They used decision support in Epic to notify providers when a patient didn’t meet criteria for blood transfusion and suggest ordering fewer units for patients who did need blood. Their efforts decreased transfusions by more than 47% and achieved an estimated savings of more than $1 million dollars per year.

To make it easier to order fewer units of red blood cells, the system suggests providers order just one unit to start. If a patient’s hemoglobin values exceed the criteria and the patient isn’t high-risk, clinicians are notified the patient might not meet guidelines for a blood transfusion. Clinicians can review the guidelines in the notification and remove the order or enter an indication for continuing with the order.

“As far as quality improvement projects go, this one was relatively easy to implement,” says Dr. Ian Jenkins, chair of the Patient Safety Committee at UCSD. “There are well-defined best practices, relatively simple order set design, straightforward education, and data was easy to collect [in Epic].”

Read more in the Patient Safety Monitor Journal.