How do we develop and implement a preoperative anemia clinic designed to improve perioperative outcomes and reduce cost?

The authors describe the development and implementation of a preoperative anaemia screening and treatment programme at Duke University Hospital. They describe 7 steps in the implementation process:
1. Institutional rationalisation of the project;
2. Determine a target pilot population;
3. Define institutional thresholds for transfusion based on haemoglobin (Hb);
4. Create a financial plan and business case;
5. Develop an institution target-specific treatment algorithm;
6. Design the clinical workflow;
7. Integrate clinical and laboratory workflow into the electronic health record (EHR).

Overall, the programme took 1 year to implement.

The article will be of interest to all those who are thinking of starting a patient blood management (PBM) programme at their institution. While the financial implications may not be applicable to different health care models, the objectives and the scientific foundations underlying the PBM programme should be common to all health care providers.

– Jean-François Hardy