Our Results … Speak for Themselves

Financial Results

• Decreased incidence of postoperative infections thereby reducing hospital charges by $15,398 per patient
  
• Reduced length of stay from 12.9 to 8.7 days (total 4.7 days), opening more beds for more admissions
• Increased net teaching hospital profits by $259,000 over 6 months of clinical management
• Attained $2 million in net savings for goods and services with clinical management in cardiovascular services program
• Demonstrated the potential first-year savings of over $600,000 in a major liver transplant program
• Attained on average a 20% reduction in transfusion in the first year of use of our program, thereby saving up to $1 million
• Decreased costs and charges for transfusion-associated infections by $12,192 per patient
• Provided C-level management team with dashboards and analyses of progress for use in budget planning
• Designed blood product usage and analysis reports for over 20 major hospitals

Clinical Results CCU, ICU

• Reduced phlebotomy wastage, leading to fewer transfusions
• Lowered direct transfusion-related costs over 18 months by $1,415,493 in teaching hospital cardiovascular services – a 23% improvement
• Lowered length of stay from 12.7 days to 6.4 over 12 months in teaching hospital cardiovascular services
• Saved $935,624 in un-reimbursed costs for “never events” over 12 months in hospital cardiovascular services
• Lowered CCU/ICU transfusion rate by 58% and ESA use by 35% over 1 year, resulting in total cost of products less than the initial cost of transfusion
• Reduced platelet use in cardiovascular services by 33.3% over 2 years
• Established simple and inexpensive devices on central lines to reduce blood wastage
• Created intravenous iron and ESA protocols for ICU/CCU patients

Pharmacy

• Reduced use of erythroietin-stimulating agents (ESA), thereby reducing pharmacy costs
• Shifted use of ESA’s to outpatient arena to reduce inpatient pharmacy budget
• Correlated ESA use and hemoglobin levels to identify and correct inappropriate use

Laboratory

• Identified savings of $320,453 in cost of lab tests over one year from clinical management
• Decreased number on unnecessary blood tests
• Reduced use of pre-admission autologus RBC donation by 70% in joint replacement patients
• Replaced pre-admission autologous (PAD) RBS use with pre-operative anemia correction, thereby avoiding need for PAD in 545 joint replacement patients
• Decreased allogeneic RBC transfusion by 55% over 1.5 years in joint replacement
• Provided policies and procedures for blood product distribution and use
• Analyzed and tracked physician and service variability in practice

Methodology Results Implementation

• Performed multi-level needs assessments both to understand hospital issues and culture and to identify areas for most effective and fruitful program change
• Provided individualized performance review to facilitate understanding and goal-directed performance improvement
• Educated staff and nurse educators in clinical management to promote ongoing change
• Provided policies and procedures for blood product distribution and use
• Analyzed and tracked physician and service variability in practice

• Provided service and physician-based benchmarks to reduce unnecessary resource use
• Realign disparate information sources, processes, methodologies and resources to create workable solutions
  
• Established ongoing peer-to-peer review and education
• Provided detailed, personalized implementation plans
• Created playbooks based on application of evidence-based medicine
• Established training program in acute normovolemic hemodilution

Results – Evidence Based Medicine

• Demonstrated relationship between anemia on admission and transfusion costs
• Established “Anemia Clinic” concept to treat patients before surgical admissions, thereby reducing transfusion use, costs, and length of stay
• Reduced length of stay in a teaching hospital joint replacement program by 17%
• Decreased transfusion-associated infections by 70%
• Decreased a sustainable decrease in the percentage of admitted anemic patients over 3 years from 29% to 8% to 10% by pre-hospital treatment
• Employed individual detailed analysis of practice and outcomes in response to “my patients are sicker” arguments
• Demonstrated that same-stay cardiac cath/surgery patients had higher transfusion products transfusions, more complications, and higher costs than cath and return patients