This August marks another landmark for the NBA, indeed for the blood sector in Australia.
My colleague Dr Alison Turner is to retire from the helm of the NBA.
Dr Turner, in accepting the role of General Manager and CEO in 2003, took on the vast and difficult task of implementing the recommendations of the 2001 Stephen Review[1].
There was a major lack of national alignment within the sector. There were a heterogeneity of approaches to contracting, procurement, governance and oversight, both across jurisdictions and elsewhere within the sector—and at that time there was little in place nationally to measure the appropriateness of blood and blood product usage, or transfusion-related adverse events.
Under Dr Turner’s stewardship, a wide range of initiatives and changes have been achieved which now form the core infrastructure for the sector.
I wish to specifically acknowledge the professional and personal support Dr Turner has given me and my role with the NBA. I wish Dr Turner well as she embarks on her next adventures and challenges.
The creation of the suite of modules comprising the Patient Blood Management Guidelines—including the release of the Critical Bleeding/Massive Transfusion module, the soon to be released Perioperative module, and the planned Medical, Critical Care, Neonatal/Paediatric and Obstetric modules—will provide a framework against which to benchmark the appropriateness of blood usage. The NBA’s enhanced data capacities will materially assist this endeavour.
Work by the NBA and DoHA on two commissioned research projects, the NBA’s work with the ACSQHC in the development of their new Blood Standard, along with the already live EQUiP 5 Australian Council on Healthcare Standards (ACHS) Standard, which includes a blood transfusion section, all align with, and provide hospitals with the tools required for, a drive to increased appropriateness in use and efficiency in the management of blood and blood products.
The ongoing work of the national Haemovigilance Advisory Committee, including the sponsorship of a consensus guideline for the Recognition and Management of Acute Transfusion Reactions–due for release in late 2011–and Australia’s contribution to the International Haemovigilance Network, provide a risk-based counterpoint to measures to improve the appropriateness of prescribing.
What then of the next few years ahead for the Australian blood sector? Of most significance is the range of data gathering and data linkage capacities which are being supported by the NBA. These will provide national and granular data in relation to usage, fate of product and the appropriateness of usage. The national roll out of BloodNet improves and standardises the approach to ordering products and the collection of data about product fate. The sector has largely been without data at this level which can be used to guide options for improvements.
Once again, I am indebted to my expert medical, nursing and scientific colleagues in the clinical sector for their ongoing contribution, in particular, to the mammoth work of developing the Patient Blood Management Guidelines, and to the review of the Criteria for the clinical use of IVIg in Australia. I am also indebted to my senior medical counterparts in the Blood Service in our work together across a wide range of issues and initiatives.
Dr Chris Hogan
Principal Medical Officer
National Blood Authority
[1] 2001 Review of the Australian Blood Banking and Plasma Product Sector, chaired by the Rt Hon Sir Ninian Stephen.