Pennsylvania Health System Improves Clinical and Financial Outcomes in Nine Months Through a Comprehensive Patient Blood Management Program

Like many health systems in 2020 and 2021, this Pennsylvania facility was exploring new opportunities to improve patient outcomes, generate revenue, and reduce unnecessary costs. Around this time, the health system became aware of several hospital reports on the clinical and fiscal impact of a comprehensive patient blood management (cPBM) program. PBM is a national patient safety initiative focused on optimizing a patient's blood health. It is patient centered, not product centered, meaning its scope includes more than merely optimal blood product management. PBM's core components include patient centered decision making, blood conservation, coagulation management, and anemia management.

The health system's leadership began to research PBM program implementation strategies and solutions.

Through its due diligence and with guidance from its Chief Medical Officer, this healthcare organization selected hc1 as their partner to implement a comprehensive PBM program. The partnership scope included program implementation services and resources from hc1's team of nationally recognized experts, PBM analytics software, and hc1’s virtual anemia management program, MyBloodHealth®. The hc1 cPBM program has been successfully implemented in 400+ hospitals across the country and uses a proven methodology for success.

Establishing a Successful, Sustainable Program Infrastructure

One of the hc1 PBM fundamentals focuses on establishing a strong program infrastructure.

For the hospital, this included establishing a clinical executive sponsor, project lead, a multidisciplinary PBM Committee, and physician stakeholders in all high blood use specialties. The health system’s PBM Committee adopted an impressively detailed charter, including oversight and responsibility for the overall program implementation plan.

Implementing Clinical Best Practices

The Patient Blood Management committee met in March of 2022, and the team immediately began working on implementation recommendations based on hc1's five PBM fundamentals.

1. Establish a clinically driven, multidisciplinary PBM program infrastructure.
2. Develop and distribute meaningful PBM reports that reflect clinical performance at the hospital, specialty, and provider level to drive ownership and accountability.
3. Implement evidence-based transfusion guidelines and effective computerized physician order entry for blood components with clinical decision support.
4. Roll out ongoing, customized clinical education and awareness campaigns focused on the most significant opportunities for improvement.
5. Implement clinical strategies to improve the recognition and management of anemia and minimize bleeding and blood loss through an anemia management program.

The Power of PBM Benchmarks and Analytics

The health system implemented hc1's cloud-based PBM Analytics suite, capable of providing hundreds of meaningful clinical reports at the hospital, specialty, and provider level. hc1 PBM Analytics is used by hundreds of hospitals across the country to quickly identify outlier behavior, variation in practice, and opportunities for improvement based on hc1's extensive benchmark dataset. In addition, PBM Analytics is vendor-agnostic, creating a smooth and seamless connection to its existing electronic medical record.

PBM Analytics enabled the healthcare system to perform a baseline analysis of hospital, specialty, and provider practice for several PBM performance metrics.

PBM Analytics and hc1's benchmarks were used to set organization targets for each metric. The metrics were carefully selected by clinical experts to drive clinical transformation. Examples of three red blood cell (RBC) metrics selected by the hospital include percentage of RBC units ordered with a pre-transfusion hemoglobin <7.0 g/dL, percentage of RBC units ordered with a pre-transfusion hemoglobin >8 g/dL, and single unit RBC orders. The software will be used prospectively to generate and distribute automated reports to clinical stakeholders throughout the health system regularly to reduce avoidable transfusions.

Anemia Management Program

The health system implemented pre-surgical anemia management (PSAM) as part of a comprehensive PBM program by leveraging hc1's innovative anemia management software tool, MyBloodHealth. MyBloodHealth is an enterprise-wide software tool that supports effective and efficient implementation of pre-surgical anemia management programs. Leadership identified the pre-surgical testing (PST) department as the champion for PSAM, leveraging existing resources (five PST nurses and three mid-level providers) to support the program. Key stakeholders evaluated current and future workflows to develop best practice process improvements, including adoption of a pre-surgical anemia algorithm and anemia management reflex lab test after approval from the PBM and medical executive committee. 

Speed to Value: Improving Outcomes and Profitability

In June 2022, twelve weeks after project kickoff, the hospital launched its anemia management program leveraging hc1's MyBloodHealth software solution.

Hospital clinicians began screening all high blood loss elective procedures and worked on improving its processes to ensure more patients were processed and optimized through the program. Over time, the anemia management program experienced an increasing patient load. Within six months, this healthcare leader was exceeding ROI goals and seeing improved patient outcomes with anemia management.

Within the first nine months of implementing the program, this Pennsylvania health system attained the following results:

The health system's initial projected impact was a conservative $10,000 per month. However, margin improvement from implementing hc1's cPBM program is currently at $28,000 per month and increasing. 

The healthcare system is actively enhancing profitability, conserving scarce resources, and most importantly improving patient safety and clinical outcomes. As the anemia management program scope expands to include additional surgical procedures, women’s health, and chronic anemia, this health system anticipates increases that are 3-5 times the current value creation associated with revenue and cost savings.