Thursday, June 11, 2009

Loyola Among First Hospitals in Nation to Limit Transfusions of Blood, Blood Products

New initiative to recycle blood, treat anemia designed to reduce patient risks, trim costs

MAYWOOD, Ill. -- Each year, more than 5 million people in the United States receive blood transfusions.

Though transfusions can be life-saving, the medical use of blood products comes with a certain amount of risk to patients from allergic reactions, overuse, infections such as HIV and hepatitis and from other complications.

Loyola University Hospital is among a handful of medical centers in the U.S. that has put initiatives in place to track and better understand those risks, along with instituting stricter measures to cut down on the number of transfusions given to patients.

"It's really a patient safety issue," said Dr. Steven Edelstein, professor, department of anesthesiology, Loyola University Chicago Stritch School of Medicine, Maywood, Ill. "At Loyola, we want to be certain that in every instance in which a transfusion of blood or blood products is considered that we balance the risk and benefit for patients."

Annually, more than 50,000 transfusions of blood and blood components take place at Loyola. Trauma victims, organ transplant patients and patients undergoing therapies for cancer are all dependent on transfusions. Transfusions are also vital for those with sickle cell anemia, some premature births and patients undergoing heart or joint replacement surgery.

Though the blood supply is the safest in history, a transfusion is in effect an organ transplant, Edelstein said. Each transfusion brings with it changes in the immune system that can lead to higher rates of infection and other complications.

"For example, it is possible that patients who have cancer and who receive a blood transfusion may be at a higher risk of recurrence. Why it occurs may be related to the immune effects of the transfusion, but it is unclear," Edelstein said.

The unit cost of blood has risen dramatically over the past decade, due chiefly to new testing of blood for infectious diseases, which also affects the bottom line at hospitals nationwide as well as at Loyola.

About a year and a half ago, Loyola's Blood Usage Committee began a Blood Management Program to study and find ways to control those costs and limit patient risks

"We're way ahead of the curve," said Edelstein, who chairs the committee. "We're being very proactive."

The committee organized a multidisciplinary blood management workshop to get input from nursing, anesthesiology, surgery, stem-cell transplantation, hematology/oncology, risk management and hospital administration. With this information in hand, the hospital developed a blood management audits and implementation plans that spells out the changes that needed to take place.

The changes are already having a positive effect. To lower the risk of anemia, intensive care nurses at Loyola are cutting down on the number of daily blood draws from patients. The hospital has also invested in blood cell salvage technologies that allow for the recycling of a patient's blood during an operation. In addition, Loyola uses drugs that can cut down on the need for transfusion and is in the process of instituting a transfusion-free surgery program under the direction of Dr. Hieu Ton-That, Department of Surgery—Trauma Division.

"The key is educating people to recognize the complications for transfusing of any blood product and how to do a better job of managing all blood therapies," Edelstein said.

About Loyola University Health System

Loyola University Health System (LUHS) is part of Trinity Health. Based in the western suburbs of Chicago, LUHS is a quaternary care system with a 61-acre main medical center campus, the 36-acre Gottlieb Memorial Hospital campus and more than 30 primary and specialty care facilities in Cook, Will and DuPage counties. Loyola University Medical Center’s campus is conveniently located in Maywood, 13 miles west of Chicago’s Loop and 8 miles east of Oak Brook, Ill. At the heart of the medical center campus is a 559-licensed-bed hospital that houses a Level 1 Trauma Center, a Burn Center and the Ronald McDonald® Children's Hospital of Loyola University Medical Center. Also on campus are the Cardinal Bernardin Cancer Center, Loyola Outpatient Center, Center for Heart & Vascular Medicine and Loyola Oral Health Center as well as Loyola University Chicago Stritch School of Medicine, Loyola University Chicago Marcella Niehoff School of Nursing and the Loyola Center for Fitness. Loyola's Gottlieb campus in Melrose Park includes the 255-licensed-bed community hospital, the Professional Office Building housing 150 private practice clinics, the Adult Day Care, the Gottlieb Center for Fitness, Loyola Center for Metabolic Surgery and Bariatric Care and the Loyola Cancer Care & Research at the Marjorie G. Weinberg Cancer Center at Melrose Park.

Trinity Health is a national Catholic health system with an enduring legacy and a steadfast mission to be a transforming and healing presence within the communities we serve. Trinity is committed to being a people-centered health care system that enables better health, better care and lower costs. Trinity Health has 88 hospitals and hundreds of continuing care facilities, home care agencies and outpatient centers in 21 states and 119,000 employees.