NYU Langone Hospital- Brooklyn, New York, United States
Background/Case Studies: Blood transfusion rates in obstetrics reflect critical care needs but pose risks and resource challenges. A multimodal, multidisciplinary strategy was implemented at NYU Langone Brooklyn’s Labor and Delivery (L&D) unit to reduce red blood cell (RBC) transfusion rates, focusing on standardized care, risk assessment, and rapid escalation protocols.
Study
Design/Methods: To evaluate whether a multimodal, multidisciplinary approach decreases RBC transfusion rates in the L&D unit, specifically targeting reductions in double-unit transfusion orders and overall transfusion rates, a retrospective study was used to analyze RBC transfusion practices in the L&D unit from 2022 to 2024. Transfusion rate was calculated as RBC units transfused per 1,000 patient days, with patient days derived from delivery numbers and average length of stay. Interventions of L&D included collaboration with Blood Bank, Bloodless Medicine, Nursing, Anesthesia, GYN Oncology, and Critical Care teams. Key strategies involved standardizing care, implementing risk assessment tools, rapid escalation protocols (OB-OHT and OB Intensivist Codes), and ensuring senior OB surgeon presence.
Results/Findings: The number of double-unit RBC transfusion orders decreased markedly from 32% in 2022 to 19% in 2024 (Figure A), driven by improved adherence to standardized protocols. Enhanced multidisciplinary coordination and rapid response systems further supported these outcomes, reducing the overall RBC transfusion rate from 20.7 units per 1,000 patient days in 2022 to 14.5 in 2024.
Conclusions: A multimodal, multidisciplinary approach effectively reduced RBC transfusion rates in the L&D unit by standardizing care and optimizing resource use. These findings underscore the value of collaborative strategies in improving patient outcomes and reducing transfusion-related risks in obstetrics. Further studies may explore scalability and long-term impacts of such interventions.
