Electronic enhancements to blood ordering reduce component waste

BACKGROUND The effect on component wastage after enhancing the clinician's ability to order blood products in the computerized physician order entry (CPOE) system was investigated in a multihospital network. METHODS A novel field was added to the CPOE of eight hospitals within a health care system allowing the physician to reserve a red blood cell (RBC) unit for transfusion at a later time. Simultaneously, an electronic means of communication with the blood bank was implemented requiring the nurse to ensure that the patient was prepared for the transfusion before a product could be issued. The wastage rates in the 12 months after these electronic enhancements (Phase 2) was compared to the preceding 19 months of a non-CPOE-based waste reduction campaign (Phase 1) and to the 24 months before the campaign (baseline period). RESULTS There were significant reductions in platelet (PLT) waste between the baseline period and Phase 1 (p < 0.05) and between Phase 2 and both Phase 1 and the baseline period (p < 0.05). The annual systemwide cost savings in wasted PLTs between the baseline period and Phase 2 was approximately $123,300. RBC waste was significantly reduced between Phase 2 and both Phase 1 and the baseline period (p < 0.05). Cryoprecipitate waste was reduced between Phase 2 and the baseline period (p < 0.05), while plasma waste did not change between the three periods. CONCLUSIONS Implementing a multifaceted approach to waste reduction led to a significant reduction in wastage for RBCs, PLTs, and cryoprecipitate.