The COVID-19 pandemic has shown how quickly the demand and supply of blood products can become unbalanced. Managing blood donation levels and inventory against a changing background of surgical cancellations, backlogs, and shifting hospital capacities has continuously highlighted the importance of using blood appropriately.

In September 2020, Choosing Wisely Canada and Canadian Blood Services launched Using Blood Wisely, a national initiative that mobilizes hospitals to take leadership in reducing inappropriate red blood cell (RBC) transfusions. In just one year, close to 200 hospitals across Canada have stepped up to participate in Using Blood Wisely. Collectively, these hospitals are responsible for two-thirds of blood transfused in Canada.*

How it works.

To participate in Using Blood Wisely, hospitals commit to conducting transfusion audits and reporting the results to Choosing Wisely Canada.

The audits are compared to national appropriateness benchmarks that include:

• At least 65%of red blood cell transfusion episodes being single-unit
• At least 80%of inpatient red blood cell transfusions having a pre-transfusion Hb 80 g/L or less

Participating sites that sustain benchmarks for at least 4 months qualify to become a Using Blood Wisely Hospital. Those who have not yet met benchmarks can participate in a quality improvement program to help get them there.

To date, close to 70 hospitals have now received the Using Blood Wisely designation and many sites are involved in the quality improvement program.

Using Blood Wisely from Coast-to-Coast 

“With close to 200 hospitals participating across the country, Using Blood Wisely demonstrates an eagerness and commitment to supporting and improving blood stewardship,” says Dr. Yulia Lin, Transfusion Specialist and Physician Lead of Using Blood Wisely. “It’s also an opportunity to recognize the significant efforts of hospitals that have shown tremendous leadership over the years and during a particularly difficult time.”

Even with the large number of hospitals involved, many more have yet to join the initiative. Transfusion data from Canadian Blood Services show that in 2019-20, there were over 500 hospitals in Canada that transfused at least 690,000 units of blood. That means it’s still a long road ahead before universal participation could be achieved.

“Canadian Blood Services applauds the hospitals that have embarked on this project and encourages all Canadian hospitals to join,” says Dr. Tanya Petraszko, Senior Medical Director, Medical, Laboratory and Stem Cell Services, Canadian Blood Services. “Hospital transfusion services are critical in helping prescribers of blood to use blood in alignment with evidence-based best practices. We are grateful for our hospital colleagues who help ensure that our patients get the right product, at the right time and in the right amount.”

What’s next?

Using Blood Wisely is now supporting hospitals with their quality improvement journey to identify and address barriers in RBC utilization.

With many provinces facing a fourth wave of the COVID-19 pandemic, there continues to be a significant need to use limited resources wisely. Hospitals are invited to participate in Using Blood Wisely and join a collective effort to strengthen Canada’s blood supply.
Get started now: https://usingbloodwisely.ca

*This information does not include Quebec, as they report to Héma-Québec.