The purpose of this study is to determine the efficiency of blood utilization for elective surgery at the University of Malaya Medical Centre (UMMC). A similar study conducted six years earlier in the same unit resulted in the introduction and implementation in December 1997 of the local Maximum Surgical Blood Order Schedule (MSBOS) and the Group Screen and Hold (GSH) procedure instead of a full crossmatch. This paper compares the findings of the current study with that conducted earlier.
Matched MeSH terms: Blood Banks/statistics & numerical data
Provision of quality care, service and blood products to patients while containing costs and the amount of blood used should be the aim of every blood bank. Therefore a prospective audit was carried out over three months to determine how efficiently blood was being used in elective surgery in the University Hospital, Kuala Lumpur. Every case with blood crossmatched was monitored to determine the amount transfused and the posttransfusion haemoglobin level. Overcrossmatching of varying degrees was noted in almost all surgical procedures and overtransfusion in 45.5% of patients transfused. The rate of case postponement was 18.1%. These indicate inefficient utilization of blood and other resources. The transfusion index (TI) and range of units transfused were calculated for each procedure. They can be used as indicators of blood requirement and potential severity of hemorrhage. Suggestions to improve efficiency of blood utilization include the introduction and ongoing monitoring of guidelines on crossmatching and transfusion based on the data obtained here, by the hospital blood transfusion committee; the "group, screen and hold" practice for surgical procedures with high crossmatch transfusion ratios, low transfusion indices and a small range of units transfused could also be adopted.