In surgical patients undergoing procedures in the MSBOS "no sample needed" category, the percent with any blood order decreased by 38.1% in the post-MSBOS/ERBS period (from 40.4% to 25.5%; P<0.001).
In the MSBOS "no sample needed" category, there was a small increase in emergency release blood transfusion from 0.4 in 1,000 patients to 1 in 1,000 patients.
In summary, at our institution, we have implemented both an updated MSBOS with clinician education and an ERBS and found that our rates of unnecessary blood orders, our C/T ratio, and associated costs decreased.
For economic census years, total industry sales are published, by commodity line, for three categories of wholesalers: merchant wholesalers, manufacturers' sales branches and offices (MSBOS), and agents and brokers.
After deflation of sales of merchant wholesalers, real output of MSBOS and agents and brokers is estimated based on an extrapolation of the change in real output of the commodities produced by manufacturers.
In this study, lower RBC unit expiration rates were documented in hospitals in which the MSBOS was not used compared to those in which the MSBOS was utilized, in hospitals in which laboratory personnel monitored requests for RBC components by transfusion indication compared to those hospitals in which laboratory personnel did not monitor such requests, and in hospitals in which short-dated units were not accepted from blood distribution centers compared to hospitals in which short-dated units were accepted.
All 3 indicators of blood utilization were lower (better performance) in hospitals that did not have medical directors of transfusion services on site full time compared to those hospitals that did have such directors, RBC unit expiration and wastage rates were lower in hospitals that did not use the MSBOS, and RBC unit wastage rates were lower in institutions that did not monitor blood wastage compared to those that did monitor blood wastage.
From this algorithm, we created our MSBOS, and it is currently being implemented at the Johns Hopkins Hospital.
By using this MSBOS to eliminate unnecessary blood orders, we estimated a potential reduction in hospital charges of more than $200,000 and in actual costs of more than $40,000 annually.