After deflation of sales of merchant wholesalers, real output of MSBOS and agents and brokers is estimated based on an extrapolation of the change in real output of the commodities produced by manufacturers.
Simultaneous with the release of our MSBOS we implemented another major advance in transfusion medicine: the remote electronic blood release system (EBRS).
With the simultaneous release of our MSBOS and rollout of the EBRS we studied the effect of these two interventions on our blood-ordering and transfusion processes.
In surgical patients undergoing procedures in the MSBOS "no sample needed" category, the percent with any blood order decreased by 38.
Decision grid Idea Feasibility Cost Likelihood Total of improving performance Unacceptable 5 2 2 20 specimens Laboratory 5 3 5 75 workflow MSBOS 3 2 3 30 for blood orders Telephone calls from 2 2 1 4 the OR Electronic 5 2 4 40 crossmatch Laboratory ambassador program 5 5 3 75 Scale 1-5 with 1 being low and 5 being high Table 4.
In this study, lower RBC unit expiration rates were documented in hospitals in which the MSBOS was not used compared to those in which the MSBOS was utilized, in hospitals in which laboratory personnel monitored requests for RBC components by transfusion indication compared to those hospitals in which laboratory personnel did not monitor such requests, and in hospitals in which short-dated units were not accepted from blood distribution centers compared to hospitals in which short-dated units were accepted.
Certainly it is possible that utilization of these practices, some of which have been shown to improve performance (such as the use of the MSBOS (15)) and others of which were likely designed to improve performance, may have indeed adversely affected performance in this study.
By using this MSBOS to eliminate unnecessary blood orders, we estimated a potential reduction in hospital charges of more than $200,000 and in actual costs of more than $40,000 annually.
AIMS-acquired data has allowed our group to compile erythrocyte transfusion data on more than 50,000 surgical procedures at our institution to develop an MSBOS with the goal of achieving appropriate preoperative blood product orders.