Multi-disciplinary patient blood management (PBM) programs — which go beyond blood bank projects to manage and preserve a patient’s own blood — can improve health outcomes, reduce the cost of care and produce an attractive financial return. These were among the main ideas from a session focused on PBM programs at Becker’s 16th Annual Meeting.

Matthew A. Warner, MD, president, Society for the Advancement of Patient Blood Management, and associate professor, Mayo Clinic (Rochester, Minn.), discussed the clinical and business benefits of PBM programs and shared tips and best practices for initiating a new program.

Here are four key takeaways from the session:

1. PBM programs optimize blood health

The World Health Organization and other international medical societies define patient blood management as a patient-centered, systemic, evidence-based approach to improving outcomes by managing and preserving the patient’s own blood.

Optimizing patients’ blood health is central to this work. The goal is to ensure that blood components — such as red blood cells, immune cells, platelets and clotting proteins — interact effectively with other systems in the body.

By detecting and treating anemia, reducing blood loss and utilizing blood products appropriately, PBM programs enable hospitals to reduce complications, lower mortality rates and increase community trust.

2. PBM programs improve financial performance

Patient blood management programs help hospitals and health systems maintain more predictable margins with less variation across service lines. Healthcare organizations worldwide report a high ROI associated with these initiatives.

For example, when Mayo Clinic launched its PBM program in 2012, 17% of hospitalized patients were transfused. Today, around 10% receive transfusions. This is a drastic reduction, despite patients being sicker. In addition, the units of blood administered per 1,000 admissions has decreased from over 600 to under 400. “Every year, we save around $7 million from transfusion reductions alone,” Dr. Warner said. “That’s a huge return on investment.”

By expanding the PBM program beyond transfusion standardization to blood health, anemia optimization and coagulation optimization, Mayo Clinic has reduced its hospital length-of-stay by 15% compared to projections without the PBM program. Mayo Clinic has also seen a 1.5% decrease in hospital adverse events like stroke, myocardial infarction and major venous thromboembolic disease.

Other PBM success stories include Western Australia Health in Perth and John Hopkins Medicine in Baltimore. Western Australia Health estimates savings over six years from its PBM program of US$78-$97 million.

Johns Hopkins Medicine has reduced transfusion-associated costs by $3 million a year, which represents a 9.6x ROI. Also, the new Bloodless Medicine and Surgery service line is generating approximately $5 million in additional revenue annually. This team supports patients who can’t receive blood products due to conflicts of conscience, religious reasons or other considerations.

3. PBM is more than a blood bank project

PBM programs often fail if they are simply a lab-driven initiative. To succeed, programs must be multidisciplinary. Teams need to buy in and rally around improving patient outcomes.

Executive alignment is critical, as is finding a leader to spearhead the PBM process. It’s also essential to measure the right things in meaningful ways. “These programs don’t require major reorganization or capital investment, but it’s important to measure what matters and show the value,” Dr. Warner explained,

Key metrics for evaluating PBM program performance include transfusion utilization rates, risk-adjusted length-of-stay, transfused vs. non-transfused patients, complication rates, costs and ROI.

4. Best practices lead to PBM program success

Dr. Warner recommended starting small and scaling PBM programs over time. “Target high-impact areas, such as perioperative anemia treatment or transfusion standardization in areas with high use and high variability,” he said.

The importance of local culture and workflows also can’t be overlooked. If PBM processes are complicated, clinicians will be reluctant to adopt them.

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