“Anytime you give a blood transfusion, there are risks involved,” said Jim Pitcher, Certified Clinical Cardiovascular Perfusionist at Mon General. “Therefore, you can decrease patient risk by not giving blood products. Mon General is well above the national average in minimizing the amount of blood needed per surgery for each of these patients.”
The clinical indicators were compiled by SpecialtyCare, the company which provides perfusionist services at Mon General. A cardiovascular perfusionist is a specialized health professional who operates the heart-lung machine during cardiac surgery and other surgeries that require cardiopulmonary bypass. The perfusionist uses a heart-lung machine to circulate blood and maintain the patient’s respiration so the cardiac surgeon can operate on a still, unbeating heart.
In compiling the data, SpecialtyCare looked at 16 benchmarks from approximately 130 heart hospitals in the United States, along with nine hospitals in Germany and a couple in Puerto Rico. Regionally, Mon General was compared to hospitals in Pittsburgh, Johnstown and Altoona in Pennsylvania, and Cumberland, MD.
The benchmarks include the amount of fluid each patient received in the Operating Room, from normal anesthesia fluids to bypass fluids, including blood products, and glucose levels. The amount of each specific type of blood product used on patients in open heart surgery, along with the direct cost, was examined.
“From a patient’s perspective, the more important benchmarks pertain to the amount of blood products they would receive when they come into the Operating Room,” Pitcher said. “We’re in the top 10 as far as the percentage of patients who do not need red blood cells and other blood products.
No other hospitals in the region made the top 10 list.
“We try to keep everything very uniform here,” Pitcher said, explaining how Mon General reached the top 10. “Everybody gets the same training and follows the same protocols. It’s really a collaborative team effort between anesthesia and perfusion to make these indicators work for us. The surgeons provide us the support we need to get the job done. You have to have all the pieces together to make it work.”
Globally, hospitals are making efforts to reduce the use of blood products.
“Data is constantly being reviewed by different organizations,” Pitcher said. “Across the country, there is a big push to reduce the amount of blood products used in surgery because there is a great patient benefit from not giving blood products. The outcomes tend to be better then when you do not give blood products.”
This is why SpecialtyCare began benchmarking the blood product use trends a year ago, so institutions can see exactly where they are, he said.
“Our goal at Mon General initially was to make the top 10, but now our goal is to stay in the top 10.” Pitcher said. We’re not satisfied with being in the top 10, we want to make sure we stay in the top 10 and keep striving for better results with the help of our docs and everybody on the support staff here. It takes a team effort to make it work.
“To me, one of the most important things for a patient having surgery to ask is ‘am going to have to have blood during my surgery or after my surgery?’” Pitcher said. “That is one of the main concerns I’ve seen from patients across the years.
“You’d like to be able to tell everybody ‘no, you will not get that, but you can’t guarantee that to anyone,” he said. “But, we can certainly do everything we can not to give them blood products. Mon General’s numbers indicate that we are doing a good job with that.
“Decreasing the amount of blood products these patients are exposed to, that’s one of our main goals here as far as creating good patient care,” he said.