(P-TS-117) Sustaining Success: A 15-Year Journey in Patient Blood Management at a Community Hospital

Background/Case Studies: As blood product collections decline and transfusion demands rise, the balance between inventory and patient need continues to narrow. Natural disasters and global health crises, such as the COVID-19 pandemic, have further stressed the national blood supply. Red blood cell (RBC) transfusions, while critical in some clinical scenarios, carry significant risks, including transfusion reactions and alloimmunization, that can prolong hospital stays. Patient Blood Management (PBM) programs aim to mitigate these risks by promoting evidence-based, judicious use of transfusions.

Study

Design/Methods: In November 2008, Missouri Baptist Medical Center (MBMC), a community hospital in St. Louis, established a Blood Utilization Committee to reduce transfusion rates and improve patient outcomes. The committee implemented evidence-based transfusion policies, clinical transfusion indicators, targeted education, and PBM performance dashboards. Despite multiple changes in laboratory leadership and staffing from 2008 to 2024 and the dissolution of the committee during the COVID-19 pandemic, the foundational PBM practices remained in place. In January 2025, the committee was reinstated as the Transfusion Committee to ensure continued adherence and evaluation of PBM initiatives.

Results/Findings: Between 2008 and 2024, RBC transfusions at MBMC decreased by 43%, from 9,691 to 5,503 units annually. The average annual transfusion volume declined from 8,761 units before the PBM program to 4,966 units post-implementation. Remarkably, transfusion rates have remained stable since 2012, indicating strong program sustainability. Financially, the PBM program contributed to significant cost savings, reducing blood product expenditures by over $9.9 million over 13 years, from a projected $30.1 million to an actual $20.1 million.

Conclusions: Long-term sustainment of a PBM program, even through organizational changes and global challenges, can yield consistent reductions in transfusion rates and substantial cost savings. This model demonstrates the critical importance of institutional commitment to PBM for improving patient safety, conserving blood resources, and maintaining resilience during times of supply strain.