Elvira Bisbe1, Albert Garcia-Casanovas2, Carles Illa3, Jordi Varela4, Misericordia Basora5, Marta Barquero6, Maria J Colomina7, Lucia González3, Axel Hofmann8,9. 1. Anaesthesia Department, Hospital del Mar Medical Research Institute, IMIM, Barcelona, Spain. 2. Perioperative Medicine Research Group, Hospital del Mar Medical Research Institute, IMIM, Barcelona, Spain. 3. Healthcare, IQVIA Spain, Barcelona, Spain. 4. Gesclinvar Consulting S. L. Avances en Gestión Clínica, Barcelona, Spain. 5. Anaesthesia Department, Hospital Clínic de Barcelona, Barcelona, Spain. 6. Anaesthesia Department, Hospital Parc Taulí de Sabadell, Sabadell, Spain. 7. Anaesthesia Department, Hospital Bellvitge, Hospitalet de Llobregat, Barcelona, Spain. 8. School of Surgery, University of Western Australia and School of Public Health Research, Perth, Australia. 9. Institute of Anaesthesiology, University Hospital Zurich, Zurich, Switzerland.
Abstract
BACKGROUND: Patient blood management (PBM) is an evidence-based care bundle with proven ability to improve patients' outcomes by managing and preserving the patient's own blood. Since 2010, the World Health Organisation has urged member states to implement PBM. However, there has been limited progress in developing PBM programmes in hospitals due to the implicit challenges of implementing them. To address these challenges, we developed a Maturity Assessment Model (MAPBM) to assist healthcare organisations to measure, benchmark, assess in PBM, and communicate the results of their PBM programmes. We describe the MAPBM model, its benchmarking programme, and the feasibility of implementing it nationwide in Spain. MATERIALS AND METHODS: The MAPBM considers the three dimensions of a transformation effort (structure, process and outcomes) and grades these within a maturity scale matrix. Each dimension includes the various drivers of a PBM programme, and their corresponding measures and key performance indicators. The structure measures are qualitative, and obtained using a survey and structured self-assessment checklist. The key performance indicators for process and outcomes are quantitative, and based on clinical data from the hospitals' electronic medical records. Key performance indicators for process address major clinical recommendations in each PBM pillar, and are applied to six common procedures characterised by significant blood loss. RESULTS: In its first 5 years, the MAPBM was deployed in 59 hospitals and used to analyse 181,826 hospital episodes, which proves the feasibility of implementing a sustainable model to measure and compare PBM clinical practice and outcomes across hospitals in Spain. CONCLUSION: The MAPBM initiative aims to become a useful tool for healthcare organisations to implement PBM programmes and improve patients' safety and outcomes.
BACKGROUND:Patient blood management (PBM) is an evidence-based care bundle with proven ability to improve patients' outcomes by managing and preserving the patient's own blood. Since 2010, the World Health Organisation has urged member states to implement PBM. However, there has been limited progress in developing PBM programmes in hospitals due to the implicit challenges of implementing them. To address these challenges, we developed a Maturity Assessment Model (MAPBM) to assist healthcare organisations to measure, benchmark, assess in PBM, and communicate the results of their PBM programmes. We describe the MAPBM model, its benchmarking programme, and the feasibility of implementing it nationwide in Spain. MATERIALS AND METHODS: The MAPBM considers the three dimensions of a transformation effort (structure, process and outcomes) and grades these within a maturity scale matrix. Each dimension includes the various drivers of a PBM programme, and their corresponding measures and key performance indicators. The structure measures are qualitative, and obtained using a survey and structured self-assessment checklist. The key performance indicators for process and outcomes are quantitative, and based on clinical data from the hospitals' electronic medical records. Key performance indicators for process address major clinical recommendations in each PBM pillar, and are applied to six common procedures characterised by significant blood loss. RESULTS: In its first 5 years, the MAPBM was deployed in 59 hospitals and used to analyse 181,826 hospital episodes, which proves the feasibility of implementing a sustainable model to measure and compare PBM clinical practice and outcomes across hospitals in Spain. CONCLUSION: The MAPBM initiative aims to become a useful tool for healthcare organisations to implement PBM programmes and improve patients' safety and outcomes.
Authors: Raúl Juárez-Vela; José Antonio García-Erce; Vicente Gea-Caballero; Regina Ruiz de Viñaspre-Hernandez; José Ángel Santos-Sánchez; Juan Luis Sánchez-González; Eva María Andrés-Esteban; Michał Czapla; Clara Isabel Tejada; Kapil Laxman Nanwani-Nanwani; Ainhoa Serrano-Lázaro; Manuel Quintana-Díaz Journal: J Clin Med Date: 2022-07-28 Impact factor: 4.964
Authors: José Antonio García-Erce; Íñigo Romón-Alonso; Carlos Jericó; José María Domingo-Morera; José Luis Arroyo-Rodríguez; Carlos Sola-Lapeña; José Luis Bueno-Cabrera; Raúl Juárez-Vela; Saioa Zalba-Marcos; Ane Abad-Motos; Vicente Gea-Caballero; Iván Santolalla-Arnedo; Manuel Quintana-Díaz Journal: Int J Environ Res Public Health Date: 2021-03-27 Impact factor: 3.390