Patient blood management key to better blood health
05 Mar 2024
bySaras Ramiya
Patient blood management, especially for women, ensures the community health thrives. Picture courtesy of Malaysian Society of Patient Blood Management (MyPBM).The key to familiarizing patient blood management (PBM) among healthcare professionals may lie in identifying PBM as a crucial part of blood health, said Sherri Ozawa, clinical director of Patient Blood Management, Englewood Health, and founding member of the Society for the Advancement of Patient Blood Management (SABM).
PBM is a patient-centered, systematic, evidence-based approach to improve patient outcomes by managing and preserving a patient’s own blood, while promoting patient safety and empowerment. Interdisciplinary blood conservation modalities, management of anemia, optimization of coagulation and patient-centered decision making are the components of PBM, which aims to improve patient outcomes.
The journey of PBM in Englewood Health started in 1995 with the effort to take care of patients for whom blood transfusion was not an option because of religious or personal reasons, said Ozawa. She and her colleagues soon discovered that these patients were actually doing quite well due to the higher standard of care provided by the multidisciplinary team in preventing and treating anemia without the use of transfusion. Their experience paved the way for the establishment of the Society for the Advancement of Patient Blood Management (SABM) in 2000.
SABM has been instrumental in disseminating the advantages of PBM and uniting experts to practice PBM. The journey of PBM thus far has been challenging especially after the COVID-19 pandemic due to lack of staff and resources as well as politic and economic uncertainties, said Ozawa. PBM is considered an unmet yet urgent need to protect, preserve, and manage patients’ own blood.
In an effort to push healthcare entities to implement PBM as a standard of care worldwide, the World Health Organization published a policy brief in 2021 titled The Urgent Need to Implement Patient Blood Management. [https://www.who.int/publications/i/item/9789240035744. Accessed on 8 February 2024.] The policy brief highlighted that almost 3 billion of the global population are affected by anemia, mainly caused by iron deficiency while more than 600 million suffer from chronic or acute blood loss and/or bleeding disorders. These conditions represent one of the biggest, largest preventable public health and health economic burdens.
When protection and preservation of patients’ own blood is neglected and immediate health problems are not managed, the result is poor outcomes including increased hospital readmissions and mortality rate, in addition to decreased quality of life and productivity. More importantly, poor blood health impacts cognitive development and performance as well as mental health, especially depression. Unfortunately, women are disproportionately affected and since women are the drivers of the family health, the community health is also tremendously affected, said Ozawa.
“… we know that there is a lot of stakeholder interest across the globe to make PBM the new normal, we are not there yet. We have a lot of work to do as a medical community,” said Ozawa. She and her co-authors provided knowledge-to-action framework on the implementation of PBM. [Anesth Analg 2023;136(2):397–407] The framework included identifying the need to implement PBM strategies and build support; adapting the evidence and guideline recommendations relevant to patient cohort; and identifying, overcoming and understanding the barriers to implementing PBM.
Notably, blood is one of the body’s organs or part of an even larger organ system that underlays and connects every other organ system. [Expert Rev Proteomics 2018;15(11):855–864] With PBM providing superior outcome and improving population health, the demand for donated blood can be reduced thus reducing the need for costly blood transfusion, said Ozawa.