STRATEGIES TO REDUCE INAPPROPRIATE USE OF BLOOD PRODUCTS

与许多其他治疗方式一样，临床决策涉及 在日常练习中，血液的使用并不总是最理想的。然而，数据却很少 从方法学上对特定药物的疗效进行了研究 旨在促进科学上适当和 具有成本效益的实践模式。该项目将开发一种可控的 两种前景看好的教育战略的多中心试验，基于印刷的和基于 面对面的教育，旨在提高血液的适当性 产品利用率。 从9家到12家医院将被配对并随机分成3家 组。其中一组医院将不接受干预，并充当 控制。另一组(“纯印刷品”组)将接受教育 反馈和其他有关最佳输血的书面材料 练习一下。第三组医院的医生(“面对面” 小组)还将接受专家的个人咨询 输血医学，为具体的实践问题量身定做 在每个机构中都会遇到。 要解决的输血做法将在仔细审计后选择 当前的做法。将继续同时对目标做法进行审计 在项目的整个生命周期中。收益和成本分析将是 作为研究不可分割的一部分，对每种干预模式进行研究。 这项工作的结果应该被证明对日益保护有价值 稀缺的血液资源，控制医疗费用，并提供新的 对提高临床适宜性方法的认识 医生和其他人的决策。

As with many other therapeutic modalities, clinical decisions involving blood use are not always made optimally in daily practice. Yet few data exist from methodologically sound studies on the efficacy of specific interventions designed to promote scientifically appropriate and cost-effective practice patterns. This project will develop a controlled multi-center trial of two promising educational strategies, print-based and face-to-face education, intended to improve the appropriateness of blood product utilization. From nine to twelve hospitals will be matched and randomized into three groups. One set of hospitals will receive no intervention and serve as controls. Another set (the "print-only" group) will receive educational feedback and other written material concerning optimal transfusion practice. Physicians in a third set of hospitals (the "face-to-face" group) will receive in addition personal consultation from experts in transfusion medicine, tailored to the specific practice problems encountered in each institution. Transfusion practices to be addressed will be chosen after a careful audit of current practices. Concurrent audit of targeted practices will continue throughout the life of the project. Benefit and cost analyses will be performed for each mode of intervention as an integral part of the research. The results of this work should prove valuable in conserving increasingly scarce blood resources, containing health care costs, and providing new understanding of methods to increase the appropriateness of clinical decision-making by physicians and others.