AABB Survey Explores International PBM Practices

A working sub-group of AABB’s Transfusion Safety/Patient Blood Management (PBM) subsection recently published findings from an international survey that examined the implementation of PBM practices and opportunities for further adoption and standardization. This survey, published this week in Transfusion, is the first by AABB to focus exclusively on PBM and the latest since 2013 to address PBM practices. It captured responses from both AABB member and non-member facilities across five World Health Organization regions.

Results indicated that PBM adoption has increased in North America since 2013, with 50.2% of respondents reporting a PBM program in place (up from 37.8%). Globally, variations in adherence to transfusion guidelines persist. While North American facilities primarily followed AABB and College of American Pathologists (CAP) guidelines, facilities outside of North America relied more heavily on national or hospital-specific protocols. Only 55.9% of participating hospitals reported having international normalized ratio (INR) thresholds for plasma transfusion in non-bleeding surgery patients. Standardized guidelines remain a critical area for improvement, the authors noted. 

The survey also highlighted advancements in diagnosing preoperative anemia, with 42.6% of North American facilities evaluating elective surgery patients for anemia (up from 28% in 2013). Additionally, 80.2% of respondents reported promoting single-unit transfusion strategies, which the authors believe may reflect successful awareness campaigns like Choosing Wisely.

Despite these gains, the survey identified several opportunities to improve PBM adherence. Overall, only 46% (126/274) of respondents reported having a PBM program in their institution in 2021.

Finally, the percentage of facilities providing PBM training increased to 61.7% (and to 58.8% in North America). While this reflects an increase among the North American facilities from 36.5% in 2013, the authors concluded that a collaborative effort involving scientific bodies, professional associations such as AABB and national policymakers will be required to educate health care providers and encourage hospitals to implement PBM programs.