Organizational monitoring of patient blood management implementation: Results of an Italian national survey

BACKGROUND AND OBJECTIVES: Patient blood management (PBM) as a standard-of-care approach, sustained by substantial scientific literature, is now widely supported by national and international recommendations and guidelines. Scientific evidence shows that PBM is a strategic tool for improving clinical outcomes, quality of life and patient safety, as well as reducing inappropriate blood component consumption and lowering healthcare costs. MATERIALS AND METHODS: Following up the previous monitoring results (a report on 2018 data) and considering new international policy documents such as World Health Organization (WHO) policy brief, the National Blood Centre (Centro Nazionale Sangue [CNS]) has developed a new survey in 2021 aimed to investigate mainly the organizational implementation of preoperative anaemia management of PBM. RESULTS: Project adherence was 70%, with 14 responding transfusion services (TSs) out of 20 involved, distributed throughout the country. TSs reporting the presence of a corporate procedure on PBM were 35.7%. Only 50% of TSs reported preparing an annual report on PBM, and of these, 90% analysed the number of anaemic patients undergoing surgery who received iron therapy in relation to the number of anaemic patients identified. All TSs conduct an analysis of the reduction in blood component consumption, but only 2 out of 14 TSs, from two different regions, conduct annual audits on PBM. CONCLUSION: This second survey made it possible to compare the main critical issues identified in the various local areas and to develop a set of recommendations for the management of an advanced PBM system to be applied throughout the country.