CPOE Reducing Inappropriate Transfusions (CRIT) Collaborative “The most cost effective opportunity to improve patient outcomes in the next quarter century will likely come, not from discovering new therapies but from discovering how to effectively deliver therapies that are known to be effective” Sean Berenholtz 2003

Introduction of Collaborative Participants CONTACTINSTITUTION Richard Chang, Geetha Puthenveetil Children’s Hospital Orange County Suresh SrinivasanChildren’s Hospital of Michigan Marvin Harper, Jenifer LightdaleChildren’s Hospital Boston Eloa Adams, Chris LonghurstLucile Packard Children’s Hospital Munirah Curtis, Sara Boblick SmithUniversity of Illinois at Chicago Calvin PopovichAll Children’s Hospital, Florida Phil Spinella Washington University, St Louis Rod Tarrago, Judy ZeirChildren’s Hospital Minnesota David RichNationwide Children’s Hospital David KaelberMetrohealth, Case Western Marissa Tucci CHU Sainte-Justine Research Center

Introduction of Collaborative Participants CONTACTINSTITUTION Colin Banas, Sean McKenna Children’s Hospital of RIchmond Lejla Music-AplencMercy Children’s Hospital Nabil HassanHelen DeVos Children’s Hospital Cynthia KaelbsRady Children’s Hospital Amy ManekerAkron Children’s Hospital Adam CampbellShriners Hospitals Irwin Gross Eastern Maine Medical Center Robert MoserCatholic Health East Brian HobermanKaiser Northern California Melissa Frei-JonesUTHSC Santa Rosa Children’s Hospital

Meeting Agenda CRIT StudyPCORI Blood Conservation Adult Centers CRIT

Collaborative Goals Provide a venue for for multiple institutions to share experiences and projects surrounding blood utilization. Utilize decision support tools to advance the adoption of evidence based practice in our institutions. Set the framework for future collaborations using effective decision support tools.

Old Way IdeaFundingExperiment Publication and presentation Integration Clinical practice IdeaFundingExperiment Publication and presentation Collaborative Integration using CDS Clinical practice New Way 5-15 years 1-2 years Blood Net SABM CRIT

Institution Committee Approval ITBaseline Data IRBCDS LiveRandomized Analysis Children’s Hospital Orange County XX Children’s Hospital of Michigan Children’s Hospital Boston XX University of Illinois at Chicago XX All Children’s Hospital, Florida Mercy Children’s Hospital XX Children’s Hospital Minnesota XXXX Nationwide Children’s Hospital MetroHealth, Case Western X Chldren’s Hospital of Richmond XX Rady Children’s Hospital Children’s National Medical Center Akron Children’s Hospital Eastern Maine Medical Center XX Shriners Hospitals UTHSC Santa Rosa Children’s Hospital XX Seattle Childrens Hospital

Baseline Data Inclusion criteria Age 1m- 18 yrs Admitted to the hospital greater than 24 hrs Exclusion Criteria Less than 1 month More than 18 yrs Congenital heart disease Hgb SS, Thal. patients Transfusions in the OR ECMO Data Total number of admissions Average pre-transfusion Hgb Transfusions Per patient day Defined as the most recent Hgb level drawn prior to transfusion All data should be broken down month to month starting January 2011

Project Timeline Transfusion -IT Approval September 2011 IRB Approval January 2013 Baseline Data February 2013 Install CDS Tool February 2013 Early Cohort March 2013 Late cohort June 2013 Project Completion 2014

Patient Centered Outcomes Research Institute “Authorized by congress to conduct research to provide information about the best available evidence to help patients and their health care providers make more informed decisions” “Intended to give patients a better understanding of the prevention, treatment and care options available, and the science that supports those options”

Patient Centered Outcomes Research Institute Letter of Intent Feb 15th Application deadline April 15th Awards announced September Start October 2013

Blood Conservation project updated Nabil, Jen, and Stacey met in early december. – Discussed the elements of a baseline survey regarding blood conservation at our institutions. – Decided to include adult and pediatric centers. – Meeting again on January 31st

Next meeting Monday Monday February 25 th 9:00 AM Spread the word!