SHM Converge Scientific Abstract ePoster Gallery-Achieving Sustainable Blood Utilization Improvement by Hospitalists via "Bloodless" Change Management Tool

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Lehigh Valley Health Network (LVHN) reported success in improving blood utilization through a hospitalist-led change management program called <strong>BLOODLESS</strong>. The initiative was designed to reduce unnecessary packed red blood cell (pRBC) transfusions in <strong>hemodynamically stable adults</strong> without severe acute hemorrhage or ischemia. The target practice was <strong>single-unit transfusion only when hemoglobin is below 7 g/dL</strong>.

The BLOODLESS framework included eight elements: <strong>Burning platform, Literature evidence, Optimization of EMR, Operationalization of change, Data sharing, Learnings through analysis and PDSA cycles, Education, Safety assurance, and Service value</strong>. It was used to support a cultural shift toward conservative transfusion practices across Hospital Medicine physicians and advanced practice clinicians.

From <strong>July 2017 to October 2024</strong>, hospitalist performance improved dramatically. The hospital medicine service achieved an <strong>81-fold improvement</strong> compared with its own baseline and performed <strong>over 50-fold better than the LVHN network overall</strong>. The percentage of double-unit RBC orders was substantially lower among hospitalists than across the full system. This demonstrates that the intervention not only changed practice but sustained that improvement over time.

A secondary benefit was financial: the program generated an estimated <strong>$31,000 in monthly acquisition-cost savings</strong> (about <strong>$375,000 annually</strong>) using a conservative unit cost estimate of $205.

The authors conclude that BLOODLESS effectively drove durable, transformational change in transfusion behavior. They suggest that similar change-management strategies could be applied to other quality improvement efforts that depend on changing clinician behavior, especially when resource scarcity makes responsible utilization essential.

Asset Subtitle

Shadi Jarjous

Meta Tag

Author List Shadi Jarjous, Warren D. Behr

Category Innovations

Concept Blood Transfusion

Concept BLOODLESS Framework

Concept Hemodynamic Stability

Concept Hemoglobin

Concept Packed Red Blood Cell Transfusion

Distinguished Non-Finalist

Presenter Organization Jefferson Health-Lehigh Valley Region

Presenting Author Shadi Jarjous

Track Value in Hospital Medicine

Keywords

Lehigh Valley Health Network

BLOODLESS

blood utilization

transfusion stewardship

packed red blood cell

single-unit transfusion

hospitalist-led change management

hemodynamically stable adults

quality improvement

cost savings

Blood Transfusion

BLOODLESS Framework

Hemodynamic Stability

Hemoglobin

Packed Red Blood Cell Transfusion