Cost pressure in the medical sector is a strong driver for a bunch of optimisation measures that might or might not influence outcome. In transfusion medicine, reducing unnecessary ordering and preparation of blood components remains an area of opportunity for optimisation. However, stretching these limits may endanger patients and worsen outcome.

Frank and co-workers investigated the implementation of a combination of a maximum surgical blood order schedule (MSBOS) and a remote electronic blood release system (EBRS). Although they state in their conclusion that implementation of MSBOS along with EBRS decreases the number of unnecessary blood orders, reduces the crossmatch-to-transfusion ratio and decreases overall costs, these results are not completely conclusive, since during the intervention period more people received a higher number of blood transfusions. Although this effect might only somewhat influence the results of their protocol, the magnitude of bias is difficult to estimate. Furthermore, safety of their bundle of measures has not been investigated, which makes interpretation of the results difficult.

However, the authors demonstrate that implementation of MSBOS along with EBRS might be worth the efforts and encourage others to perform further studies.

– Jens Meier

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