Maturity Assessment model for Patient Blood Management to assist hospitals in improving patients' safety and outcomes. The MAPBM project
Elvira Bisbe 1 , Albert Garcia-Casanovas 2 , Carles Illa 3 , Jordi Varela 4 , Misericordia Basora 5 , Marta Barquero 6 , Maria J Colomina 7 , Lucia González 3 , Axel Hofmann 8 9 , MAPBM Working Group; Luís Enrique Fernández Rodríguez 10 , Ana Abad Gosálbez 11 , Ana Peral/Ino Fornet 12 , Xavier Soler 13 , Teresa Planella 14 , Paloma Ricos 15 , Rosa Goterris 16 , Luis Olmedilla 17 , Carles Jericó 18 , Ana Morales 19 , José María García Gala 20 , Virginia Dueñas 21 , Carmen Fernández 22 , Raquel Tolos 23 , Maria Angeles Villanueva 24 , Concha Cassinello 25 , Ignacio Fuente Graciani 26 , Sonsoles Aragon 27 , Maricel Subira 28 , Violeta Turcu 29 , S A Dolores Vilariño 30 , Elena Zavala 31 , Luz María González 32 , Gemma Moreno 33 , Silvia Ruiz de Gracia 34 , Almudena García 35 , Antonio Pérez Gallofre 36 , Paula Duque 37 , Luis López Sánchez 38 , José Manuel Vagace 39 , Ángeles Medina 40 , Mar Orts Rodríguez 41 , Ana Faura 42 , Lola Rosello 43 , Eric Johansson 44 , Pere Poch 45 , María A Santamaría 46 , Montserrat López Rubio 47 , Irene Jara 48 , Cristina Carmona 49 , Cristina Ramió Lluch 50 , Martínez Almirante 51 , Ángel Fernández López 52 , Mila Caldes 53 , Elvira Loureiro 54 , Miguel Quintana 55 , Gonzalo Azparren 56 , Jorge Puerta 57 , Eva María Romero 58 , Ana Arroyo Rubio 59 , Juan Santaella 60 , Gabriel Cerdan 61 , Rosalía Arbones 62 , Ángela Palacios 63 , Pilar Llamas 64
Background: Patient blood management (PBM) is an evidence-based care bundle with proven ability to improve patients' outcomes by managing and preserving the patient's own blood. Since 2010, the World Health Organisation has urged member states to implement PBM.
However, there has been limited progress in developing PBM programmes in hospitals due to the implicit challenges of implementing them. To address these challenges, we developed a Maturity Assessment Model (MAPBM) to assist healthcare organisations to measure, benchmark, assess in PBM, and communicate the results of their PBM programmes.
We describe the MAPBM model, its benchmarking programme, and the feasibility of implementing it nationwide in Spain.
Materials and methods: The MAPBM considers the three dimensions of a transformation effort (structure, process and outcomes) and grades these within a maturity scale matrix. Each dimension includes the various drivers of a PBM programme, and their corresponding measures and key performance indicators.
The structure measures are qualitative, and obtained using a survey and structured self-assessment checklist. The key performance indicators for process and outcomes are quantitative, and based on clinical data from the hospitals' electronic medical records. Key performance indicators for process address major clinical recommendations in each PBM pillar, and are applied to six common procedures characterised by significant blood loss.
Results: In its first 5 years, the MAPBM was deployed in 59 hospitals and used to analyse 181,826 hospital episodes, which proves the feasibility of implementing a sustainable model to measure and compare PBM clinical practice and outcomes across hospitals in Spain.
Conclusion: The MAPBM initiative aims to become a useful tool for healthcare organisations to implement PBM programmes and improve patients' safety and outcomes.
CITA DEL ARTÍCULO Blood Transfus. 2020 Sep 18. doi: 10.2450/2020.0105-20