Implementation Of Patient Blood Management In Clinical Routine (Pbmcert)

Background: Patient Blood Management ( PBM) is a multidisciplinary approach to reduce anaemia, avoid unnecessary blood loss, and enhance the appropriate use of blood products in order to improve patient safety. The WHO strongly recommended this concept in 2010, however, its implementation in clinical routineis still incomplete. To support hospitals to implement PBM, the German PBM Network was founded in 2014.Methods: The German PBM Network offers certification by a self-assessment of its members (PBMCert), in which the implementation of more than 100 different PBM measures divided into 6 thematic clusters are to be evaluated. We analysed the self-assessment protocols of certified hospitals to determine the degree of implementation of recommended PBM measures.Results: A total of 21 hospitals performed self-assessments between August 2017 and September 2019. Overall, more than two-thirds of all available PBM measures (70.8 %) were implemented to a moderate or high degree. In general, university hospitals reached higher scores compared to non-university-hospitals (79.1 % versus 68.2 %). Due to the individualised and stepwise implementation of PBM the differences between hospitals presented a broad range. Overall, PBM measures of the cluster "Optimising Coagulopathy" were well established (82.0 %), whereas measures of the clus-ter "Interdisciplinary Blood Conservation Modalities" exhibited a lower implementation rate ( 58.7 %). Highly effective PBM measures such as the preoperative administration of intravenous iron (85.7 %), the use of a coagulation algorithm for the administration of blood products (95.2 %), the calculated administration of antifibrinolytics (100 %), the conservation of physiological conditions like normothermia (100 %), a restricted frequency of blood collection (90.5 %), the application of cell salvage in cases of high blood loss (100 %), as well as a single-unit policy concerning RBC units and platelet concentrates (90.5 %), were implemented by the majority of certified hospitals.Conclusions: PBM certification enables hospitals not only to analyse their internal strengths and potentials, but also reveals that all hospitals which pursued PBM and gained the certification achieved on average more than 70 % of all PBM measures in their PBM programmes. Thus they indirectly demonstrate that patient safety is highly important.