The business of patient blood management in adults and pediatrics
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The Business of Patient Blood Management in Adults and Pediatrics PowerPoint PPT Presentation


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The Business of Patient Blood Management in Adults and Pediatrics. Dominic Sanfilippo M.D. Richard Melseth Conflict of Interest Statement. Ten-Year Experience. 670 Beds (100 ICUs) Level 1 Trauma Center 1800 physicians (50 specialties) 36,000 inpatients/year Teaching Hospital

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The Business of Patient Blood Management in Adults and Pediatrics

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The Business of Patient Blood Management in Adults and Pediatrics

Dominic Sanfilippo M.D.

Richard Melseth

Conflict of Interest Statement


Ten-Year Experience

670 Beds (100 ICUs)

Level 1 Trauma Center

1800 physicians

(50 specialties)

36,000 inpatients/year

Teaching Hospital

Surgery, IM, FP, OB/GYN, Ortho, Med/Ped

16 Operating Rooms

Transplants

Kidney, Pancreas, Liver, BMT

High-Risk OB

Competition for Capital $$$


Key Elements of a Business Proposal

  • Use hospital capital planning format and process

  • Use SABM Business Plan resources

  • Align with Hospital/System Strategic Plan

  • Fundamentals - why, what, who, when, how?

  • Include proposal and business elements

    ~ See Handout ~


Find the Opportunity – Quality and Money

  • Data collection on current transfusion, blood loss, lab draw practice variations

  • Find cost of transfusion locally

  • Benchmark with literature: cost savings, decrease in complications and utilization

  • Make case for efficient care – less cost, lower LOS, better outcomes

  • Align with quality initiatives of your hospital ; which are becoming national via “the commission” and CMMS – value based purchasing


Quality Measures to Be Used under Medicare’s Hospital Value-Based Purchasing Program

  • Clinical process

    • AMI, heart failure, pneumonia, infections, surgery (beta blockers…)

  • Patient experience (communications…)

  • Patient mortality

  • Hospital-acquired conditions

  • Patient safety


Adult Program vs. Pediatric

  • Pre-op Anemia Clinic value/cost savings

  • Decreased LOS allows more efficient use of OR and inpatient beds

  • Decrease transfusion cost, complications

    ~ See Handout ~


Properly Structured Business Plan will:

  • Justify additional $$ resources (staff, Pre-op Surgical Assessment Clinic)

  • Share PBM vision w/multiple disciplines & hospital services

  • Ensure customer satisfaction (i.e., physician, patient and employees)

  • Serve as roadmap for annual evaluation & process improvements (e.g., strategic objectives)


Pediatric Challenges

  • Smaller volumes of patients and blood

  • Less preoperative anemia in elective surgeries

  • Fear and loathing of health care reform

  • Competition for capital

  • All make revenue enhancement difficult in a performa for a Pediatric Program


“Classic” Justification: in Peds not just a performa

  • Lower transfusion/lab incidence and cost

  • Decrease complications, decrease LOS, vent days, etc.

  • Support of surgical services, more patients

  • Decrease practice variation, comply with evidence based medicine

  • Enhance reputation of institution, innovation

  • Research value = quality = comparative effectiveness


Pediatric Advantages

  • Mission driven – “what’s best for kids”

  • Foundation support

  • Recognition of research value

  • Support because it is important to the clinicians to improve care, impact community

  • Dollar, performa justification “the least important thing” to my up reports

  • The value of the program is beyond the initial dollar impact of transfusion thresholds, microsampling, lab frequency as it adds to our care in multifaceted ways


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