Maturity Assessment Model For Patient Blood Management To Assist Hospitals In Improving Patients' Safety And Outcomes. The Mapbm Project

Elvira Bisbe,Albert Garcia-Casanovas, Carles Illa,Jordi Varela,Misericordia Basora,Marta Barquero,Maria J Colomina, Lucia González,Axel Hofmann, Luís Enrique Fernández Rodríguez, Ana Abad Gosálbez, Ana Peral/Ino Fornet, Xavier Soler, Teresa Planella, Paloma Ricos,Rosa Goterris,Luis Olmedilla, Carles Jericó,Ana Morales, José María García Gala, Virginia Dueñas, Carmen Fernández,Raquel Tolos, Maria Angeles Villanueva,Concha Cassinello, Ignacio Fuente Graciani, Sonsoles Aragon, Maricel Subira, Violeta Turcu, S A Dolores Vilariño,Elena Zavala, Luz María González,Gemma Moreno, Silvia Ruiz de Gracia, Almudena García, Antonio Pérez Gallofre,Paula Duque, Luis López Sánchez,José Manuel Vagace, Ángeles Medina, Mar Orts Rodríguez,Ana Faura, Lola Rosello, Eric Johansson, Pere Poch, María A Santamaría,Montserrat López Rubio, Irene Jara, Cristina Carmona, Cristina Ramió Lluch, Martínez Almirante, Ángel Fernández López, Mila Caldes, Elvira Loureiro, Miguel Quintana, Gonzalo Azparren, Jorge Puerta, Eva María Romero, Ana Arroyo Rubio, Juan Santaella, Gabriel Cerdan, Rosalía Arbones, Ángela Palacios, Pilar Llamas

BLOOD TRANSFUSION(2021)

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摘要
Background - Patient blood management (PBM) is an evidence-based care bundle with proven ability to improve patients' outcomes by managing and preserving the patient's own blood. Since 2010, the World Health Organisation has urged member states to implement PBM. However, there has been limited progress in developing PBM programmes in hospitals due to the implicit challenges of implementing them. To address these challenges, we developed a Maturity Assessment Model (MAPBM) to assist healthcare organisations to measure, benchmark, assess in PBM, and communicate the results of their PBM programmes. We describe the MAPBM model, its benchmarking programme, and the feasibility of implementing it nationwide in Spain.Materials and methods - The MAPBM considers the three dimensions of a transformation effort (structure, process and outcomes) and grades these within a maturity scale matrix. Each dimension includes the various drivers of a PBM programme, and their corresponding measures and key performance indicators. The structure measures are qualitative, and obtained using a survey and structured self-assessment checklist. The key performance indicators for process and outcomes are quantitative, and based on clinical data from the hospitals' electronic medical records. Key performance indicators for process address major clinical recommendations in each PBM pillar, and are applied to six common procedures characterised by significant blood loss.Results - In its first 5 years, the MAPBM was deployed in 59 hospitals and used to analyse 181,826 hospital episodes, which proves the feasibility of implementing a sustainable model to measure and compare PBM clinical practice and outcomes across hospitals in Spain.Conclusion - The MAPBM initiative aims to become a useful tool for healthcare organisations to implement PBM programmes and improve patients' safety and outcomes.
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关键词
Patient Blood Management, patient safety, transfusion, maturity assessment, benchmarking
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