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Premier, AABB urge standardization in blood use

Premier’s partnership with the American Association of Blood Banks (AABB) is a

win-win situation for both organizations, said organizers of Premier’s newest
Clinical Performance Initiative designed to improve the quality, safety, and cost
of blood and blood products. This yearlong collaborative effort kicked off Sunday
in Dallas, Texas at a Premier-sponsored conference called Blood Forum 2001.

"AABB’s Standards for Blood Banks and Transfusion Services are the cornerstone of
good transfusion practice. They set the standard nationwide for transfusion
services," said Pat Lapekas, MHA, MT (ASCP), project director for the blood
services initiative and Premier’s Clinical Laboratory Services. "These Quality
System Essentials, a key component of AABB’s standards, are a critical tool in
managing ongoing operations, reducing errors and accidents and controlling the
implementation of change within the transfusion service."

The Quality System Essentials (QSEs) are a 10-point plan of technical and quality
requirements familiar to most blood bankers. They constitute the foundation of
AABB’s proposed New Standards for Blood Banks and Transfusion Services that AABB
says will improve the safety and quality of the nation’s blood supply.

According to the AABB Web site, the organization formed in 1947. It is an

international association of blood banks and more than 2,200 hospitals, community
blood centers, transfusion and transplantation services that are responsible for
virtually all of the nation’s blood supply and 80 percent of all transfusions in
the United States. Association members are located in all 50 states. "The AABB,"
said the Web site promotional literature, "supports high standards of medical,
technical and administrative performance, scientific investigation, clinical
application and education, and is dedicated to encouraging the voluntary donation
of blood and other tissues and organs through education, public information and

Regarding the Premier and AABB partnership, "There is a commitment to quality,"

said Dr. Kathleen Sazama, a member of the AABB board and the keynote speaker for
the Blood Forum 2001 CPI kickoff. "It sends a message that keeping blood safe and
making it safer is a life-long process."

Dr. Sazama’s overview of safety, called "Transfusion Fatalities: A 20-Year

Review," was presented in front of nearly 100 Premier hospital representatives.
Sazama examined 20 years of Federal Food and Drug Administration data that showed
that the biggest cause of reported hospital deaths in the U.S. was transfusing
blood to the wrong patient.

Between 1976 and 1995, according to Sazama, there were 559 reported hospital
deaths related to blood transfusions, of which five percent were from
inappropriate ‘blood type’ transfusions. "The risk of getting the wrong blood type
in a hospital is one in 20,000. The risk from dying from the mistake is one in
33,000." According to the AABB, 14 million units of whole blood are donated
annually in the United States. Nearly 4.5 million patients require blood
transfusions per year.

In her study, Sazama concluded that mandatory FDA guidelines for reporting blood
transfusion errors have done little to improve patient outcomes.

"Where we are today is where we were in 1976. We need to focus on patient

identification … that would eliminate more than half of all (transfusion) deaths
in hospitals."

Clinical laboratory directors and managers, blood bank supervisors, physicians,

utilization managers, chief executive officers, and nursing officers were among
the Premier hospital representatives who attended this event. They will spread the
word about Sazama’s call for improving blood safety to the other 1,800 Premier
hospitals. In total, members spend more than $1 billion yearly in blood and
related products.

Over the next year, these collaborators will share best-evidenced best practices,
participate in telephone conferences with Blood Forum CPI project directors; and
submit data from their blood banks and hospitals for analysis by Premier
statisticians and other experts.

Collaborators will also learn how to implement the AABB standards and make them
more effective for their organizations. "It’s a unique opportunity for sustainable
improvements in transfusion services," said Lapekas "that will help them reduce
blood waste, improve quality in testing in patient care; reduce potential
accidents and errors; and reduce overall cost for transfusion services."

If you’d like more information about the Blood Forum CPI, contact Pat Lapekas at
704.733.5018. This CPI will be closed to new collaborators by June 15, 2001.

Posted: 5/31/01