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Innovations in Blood Procurement and Utilization Bring Savings and Improved Patient Safety

James M. Crawford, MD, PhD, FCAP

James M. Crawford, MD, PhD, FCAP, came to North Shore-LIJ (NSLIJ) Health System in New York in 2009, when coordinated care was just picking up steam. He joined a forward-looking health system intent upon building a model-integrated health care network in a service area of 7 million patients.

Shortly after arriving from the University of Florida Medical Center at Gainesville, where he had chaired the Department of Pathology, Immunology, and Laboratory Medicine, Dr. Crawford took responsibility for investigating the reasons for highly variable blood utilization across NSLIJ sites of care. In such a huge system (16 hospitals/2,400 physicians), small ripples could have a large impact. Did the numbers reflect higher clinical acuity at some sites versus others? Or was NSLIJ as a whole overutilizing blood products?

Action/Solution

James M. Crawford, MD, PhD, FCAP, came to North Shore-LIJ (NSLIJ) Health System in New York in 2009, when coordinated care was just picking up steam. He joined a forward-looking health system intent upon building a model-integrated health care network in a service area of 7 million patients.

Shortly after arriving from the University of Florida Medical Center at Gainesville, where he had chaired the Department of Pathology, Immunology, and Laboratory Medicine, Dr. Crawford took responsibility for investigating the reasons for highly variable blood utilization across NSLIJ sites of care. In such a huge system (16 hospitals/2,400 physicians), small ripples could have a large impact. Did the numbers reflect higher clinical acuity at some sites versus others? Or was NSLIJ as a whole overutilizing blood products?

Summary

Properly constructed guidelines can enable pathologists to identify and document those laboratory findings most useful to their clinical partners. Intentional communication within medical teams will further free up physicians' collective bandwidth by creating a continuous feedback loop that informs and educates all parties about how best to share what they know and what they need to know. Patients benefit, efficiencies multiply, economies emerge. People start thinking about doing things differently. And from there, as the saying goes, the sky's the limit.


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