STRATEGIES TO REDUCE INAPPROPRIATE USE OF BLOOD PRODUCTS

与许多其他治疗方式一样， 在日常实践中，血液的使用并不总是最佳的。 然而，数据很少 存在于方法学上合理的研究， 旨在促进科学上适当和 具有成本效益的实践模式。 该项目将开发一个受控的 多中心试验的两个有前途的教育战略，印刷为基础， 面对面的教育，旨在提高血液的适当性 产品利用率 9到12家医院将被随机分为3个 组 一组医院将不接受干预， 对照 另一组（“仅打印”组）将接受教育 关于最佳输血的反馈和其他书面材料 实践 第三类医院的医生（“面对面” 小组）将接受专家的个人咨询， 针对输血医学的具体实践问题， 在每个机构都遇到过。 将在仔细审核后选择要解决的输血实践 目前的做法。 将继续对目标做法进行同步审计 在整个项目的生命周期中。 效益和成本分析将 作为研究的一个组成部分，对每种干预模式进行了评估。 这项工作的结果应该证明是有价值的， 稀缺的血液资源，控制医疗保健成本，并提供新的 了解提高临床适当性的方法 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.