6 Implementing, evaluating and maintaining the guidelines
The NBA, in collaboration with the Steering Committee and EWG members, developed a plan to guide appropriate communication on the implementation of this module. The plan identifies target audiences for the module, strategies and tools for effective implementation, communication channels and key messages.
Continued re-evaluation of the guidelines is necessary to reduce variation in practice patterns, support appropriate use of blood component therapy and reduce in appropriate exposure of patients to blood components.295 A plan was designed to evaluate implementation of the six modules of the guidelines and to determine:
- the extent to which the guidelines influence changes in clinical practice and health outcomes
- what factors (if any) contribute to noncompliance with the guidelines.
The results of the evaluation will be used to inform future review of the guidelines. Economic issues were considered when formulating the evidence-based recommendations, and the recommendations will have cost implications. Savings are expected to be derived from reduced use of product and an associated reduction in hospital and laboratory costs. However, the CRG anticipates that additional costs will be incurred due to the system re-design and training associated with wider implementation of preoperative anaemia assessment and treatment, improved collection and use of data to inform practice, introduction of new surgical techniques and wider uptake of other technologies such as cell salvage. While economic models have indicated a net benefit from the implementation of patient blood management practices,14,15 no economic model has been developed for the Australian setting. The NBA, together with the JBC and key stakeholders, is developing a program to facilitate uptake of the guidelines that take into account the challenges raised in Section 5.2. A number of initiatives have commenced, including initial investment in the development of a patient blood management toolkit that will help jurisdictions and individual hospitals to implement patient blood management practices. Patient blood management content has been included in nationally available education programs such as the BloodSafe eLearning Program and the Post Graduate Certificate in Transfusion Practice that is available through the University of Melbourne. Also under development is a national data dictionary that will facilitate data linkage and thus support jurisdictional evaluation of appropriate use of red cells.
This module will be reviewed and amended in 5 years unless an issue arises (e.g. new clinical evidence relevant to practice) that triggers a need for an earlier review.
The Principal Medical Officer of the NBA will convene the group of experts to undertake the review, and will be the person who can be contacted on major issues, events or practice changes.
To provide feedback and inform future reviews of this module, please send any comments on its content or implementation, or on the accompanying materials, to:
- Email: firstname.lastname@example.org
- Mail: Patient Blood Management Guidelines
National Blood Authority
Locked Bag 8430
Canberra ACT 2601
- Fax: (02) 6151 5300
Any correspondence will be forwarded to the Principal Medical Officer for consideration in the next scheduled review.
A list of colleges and societies that have endorsed this module of the guidelines will be available on the NBA website.