Screening of Transfusion Service Requests by the Blood Bank Pathologist: Impact on Cost Containment

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Abstract
To implement a rational program for use of transfusion services and, simultaneously, to reduce, if possible, expenditure for transfusable blood products, the University of Texas M.D. Anderson Hospital Blood Bank, Houston, developed a systematic screening program of all requests for transfusion. Evaluation of the requests included a short review of the patient#x0027;s hemoglobin level, platelet count, coagulation profile, and/or the pertinent transfusion history of the patient and the disease state. This evaluation often prompted the clinical pathologist to provide a nonrequested consultation to assure appropriate transfusion therapy. In four years, these steps reduced transfusion of red blood cells by 18.6%, platelet concentrates by 44.1%, and fresh-frozen plasma and cryoprecipitate by 56.6%, which resulted in a reduction in patient charges of between $700,000 to $800,000 per year. By periodically making rounds with attending physicians and house staff, the blood bank pathologist has an opportunity to reinforce section policies and improve the education of, communication with, and understanding of colleagues and patients.

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