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ForwardTransfusing Wisely - Implementing a Transfusion Quality Improvement Project: An SHM Choosing Wisely Quality Improvement Implementation Module
Ian Jenkins, MD, SFHM
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 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.
Estimated time to complete: 1 hour
Additional Information
| Attachment | Size |
|---|---|
 References - Transfusing Wisely | 82.96 KB |
Ian Jenkins, MD, SFHM
Dr. Jenkins reports having no relevant financial or advisory relationships with corporate organizations related to this activity.
Additional planners and faculty for this activity have no relevant relationships to disclose.
Conflict of Interest Disclosure Policy
In accordance with the ACCME Standards for Commercial Support, SHM requires that individuals in a position to control the content of an educational activity disclose all relevant financial relationships with any commercial interest. SHM mitigates all conflicts of interest to ensure independence, objectivity, balance, and scientific rigor in all its educational programs. All relevant financial relationships shall be disclosed to participants prior to the start of the activity.
Furthermore, SHM seeks to verify that all scientific research referred to, reported, or used in a continuing medical education (CME) activity conforms to the generally accepted standards of experimental design, data collection, and analysis. SHM is committed to providing its learners with high-quality CME activities that promote improvements in healthcare and not those of a commercial interest.
Accreditation Statement
The Society of Hospital Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
Credit Statement Designation
The Society of Hospital Medicine designates this activity for a maximum of 1 AMA PRA Category 1 Credit(s)TM. Physicians should only claim credit commensurate with the extent of their participation in the activity.
Available Credit
- 1.00 AMA PRA Category 1 Credit™
- 1.00 Non-physician
Price
The following is an interactive educational module designed to help you gauge your basic knowledge of the topic and then direct you to areas you may need to focus on. It consists of several sections, and all sections must be completed to receive CME credit.
Click START to begin.