Sparrow Health System in Lansing, Michigan, has won a 2018 HIMSS Davies Enterprise Award for its work using evidence-based best practices to reduce non-emergent blood transfusions.

WHAT HAPPENED

Sparrow recognized that overuse of red blood cell and platelet transfusions was a significant problem – one that was exposing patients to potential harms and wasting a finite, expensive resource. To address this, the health system set a three-year goal of increasing compliance with evidence-based best practice guidelines for blood product use.

Sparrow addressed these challenges through a multidisciplinary effort that replaced standalone blood product orders with evidence-based, guideline-compliant order sets. Clinical decision support tools were integrated in the electronic health record for compliance reports, which encouraged transfusion orders only with documented, appropriate indications.

This discouraged the ordering of more than one unit of red blood cells in non-emergency situations. Provisions were also made for one-click ordering for urgent or massive transfusions when necessary.

WHY IT MATTERS

As a result, Sparrow was able to improve the ordering of blood products according to evidence-based red blood cell and platelet transfusion indications and single unit red blood cell transfusion protocols, which led to a 32 percent and 25 percent decrease in transfused red blood cell and platelet units, respectively. This equates to 9,572 fewer red blood cell units and 2,391 fewer platelet units transfused from 2013 to 2017, Sparrow said.

Based on adverse event frequency data, Sparrow estimated that decreased blood product use prevented one red blood cell transfusion-related acute lung injury, 100 transfusion-associated circulatory overloads, and between 100 and 300 hives reactions.

Since red blood cell and platelet transfusions also take up considerable nursing and blood bank staff time, decreasing transfusions by nearly 12,000 units saved approximately 15,000 hours of nursing time and 12,000 hours of blood bank staff time, Sparrow said.

The organization was not only able to expose fewer patients to the risks, costs and side effects of unnecessary blood product transfusions but also improved efficiencies and decreased the stress, time and expenses for doctors, nurses and blood bank staff to respond to transfusion reactions and investigate their causes, Sparrow added.

THE LARGER TREND

Seventy-four percent of healthcare provider organizations use clinical decision support technology, according to a new study from Reaction Data, relying on CDS to make more informed medication orders (30 percent), lab orders (24 percent), medical imaging orders (20 percent), choosing wisely (13 percent) and other (13 percent).

The report polled interviewed 180 clinical, quality and IT healthcare leaders at in providers nationwide (91 percent were acute care facilities and 9 percent were ambulatory) to assess the state of clinical decision support technology in the U.S. healthcare industry today.

The Reaction Data study particularly matters because it defines the vendor marketplace for clinical decision support systems as used by healthcare provider organizations today.

The top 11 clinical decision support tech vendors in use today, according to the report: Cerner (25 percent), EPSi/Allscripts (14 percent), Epic (11 percent), Stanson Health (6 percent), Nuance (5 percent), Premier (5 percent), Truven/IBM (4 percent), Elsevier (4 percent), Zynx Health (3 percent), NDSC/Change (2 percent) and CPSI/Evident (2 percent).

ON THE RECORD

"We are honored to have earned the Davies Award. All of our information systems initiatives are focused on ensuring the finest possible experiences for patients, consumers, physicians, nurses and caregivers in every role," said Dennis Swan, president and CEO of Sparrow Health System, in a statement. "We continuously seek to learn, grow and improve."

Source: Read Full Article