Both parameters were influenced by number of beds, existence of teaching program, use of MSBOS program, or on-site full-time medical director of transfusion services.
Policies and Decisions in the Clinical Process Control in Transfusion Medicine Service Clinical Process Control Cleveland Clinic Abu Dhabi Setup Blood orders Establish orders for Prepare Red Blood Cell, Crossmatch and Hold, Transfuse Red Blood Cells, (same for other blood components) Remote allocation of units Use of peripheral fridges in operating in peripheral fridges rooms, managed by Blood Bank using an IT program Blood-warming devices Policy and procedure for maintenance and checking of blood-warming devices PBM program Creation of a transfusion safety officer position to address the PBM program MSBOS protocol Establish MSBOS electronically Inventory control and Establish inventory levels based on monitoring of wastage weekly transfusion activity.
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 38.1% in the post-MSBOS/ERBS period (from 40.4% to 25.5%; P<0.001).
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.
Also encouraging the use of inventory sharing between trading partners in the industry is the composition of the industry, The motor vehicle and automotive parts and supplies industry is one of only two wholesale industries in which manufacturers' sales branches and offices (MSBOS) have greater sales than merchant wholesalers.
For economic census years, total industry sales are published, by commodity line, for three categories of wholesalers: merchant wholesalers, manufacturers' sales branches and offices (MSBOS), and agents and brokers.
In the first study, lower RBC unit expiration and wastage rates were documented in hospitals with 200 or fewer beds compared to those hospitals containing greater than 200 beds, and lower RBC unit wastage rates were found in hospitals that did not use the MSBOS compared to those that did use the MSBOS.
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.
From this algorithm, we created our MSBOS, and it is currently being implemented at the Johns Hopkins Hospital.
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.