Transfusing Wisely - Implementing A Transfusion Quality Improvement Project: An SHM Choosing Wisely Quality Improvement Implementation Module

Transfusing Wisely - Implementing A Transfusion Quality Improvement Project: An SHM Choosing Wisely Quality Improvement Implementation Module is organized by Society of Hospital Medicine (SHM).,,Course opens: 11/09/2020,Course expires: 11/09/2023,,Overview:,Mounting evidence shows that the American healthcare system costs too much for the results it achieves in terms of patient outcomes and access. Many different parts of this system need attention, and it can be difficult to know where to begin. However, the inpatient / hospital environment is a “high intensity” healthcare delivery setting, and the “Choosing Wisely” initiative of the American Board of Internal Medicine (ABIM) offers a list of low value healthcare practices which make great targets for improvement efforts. In this module, we will tackle one of the top five practices chosen for Choosing Wisely by the Society of Hospital Medicine (SHM): excessive transfusion. ,,Objectives: ,This module is intended to prepare hospitalists to participate in Quality Improvement (QI) projects related to inpatient transfusion for adults. By the end of the module, the reader should be able to:,• Understand transfusion science well enough to advocate for restrictive transfusion practices ,• Apply the steps of the “QI Roadmap” to transfusion QI projects,• Describe successful QI transfusion projects and identify key interventions that could improve transfusion practices at their hospital.,,Key Points:,• Transfusion thresholds should be individualized based on condition and symptoms.,• In most clinical settings, the literature supports 7 g/dL of hemoglobin as a transfusion threshold for most patients (8 for those with active ischemia of the brain or heart).,• Transfusion QI projects can yield large financial savings and reduce patient harm.,• Most successful projects have used order set revisions enhanced with decision support, education, and other methods.