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Exit Survey
 
 
Dear Patient Blood Management Program Coordinator/Director,

You are invited to participate in our survey of hospital based Patient Blood Management (PBM) program leaders. PBM programs are a relatively new concept for US hospitals and data that can be used by PBM program leaders to improve their effectiveness is needed. Your contributions to this survey will give program leaders like yourself information about US PBM programs and factors that contribute to their effectiveness.

Your participation in this survey is entirely voluntary and there are no correct or incorrect answers. Your responses will be completely confidential and results will reported only in aggregate. Your data will be de-identified and will never be shared with another hospital. This survey requests information that may need to be gathered from other areas such as blood utilization reports. It will ask about your PBM program structure, effectiveness measures your facility monitors, and indications for transfusion. It will take approximately 25 minutes to complete. If you feel uncomfortable answering any of the questions you may withdraw at any time. If you have any questions about the survey you may contact Sandra Lamm at [email protected].

Thank you very much for your participation. The information you supply will be very useful. Please start the survey by answering the consent and clicking on "next".

Sincerely,

Sandra Lamm MT (ASCP), CLS (NCACLP), MSHA
Blood Bank Supervisor
VCU Health


ELECTRONIC CONSENT:

Clicking on the "I agree" button below indicates that:

• You have read the above information
• You voluntarily agree to participate


If you do not wish to participate in the research study, please decline participation by exiting the survey.
 
 
 
* Does your hospital or health system have a formal patient blood management (PBM) program?
 
Yes
 
No
 
 
 
What is your background?
 
Advanced practice nurse
 
Medical Laboratory Scientist
 
Physician
 
Physician assistant
 
Registered Nurse
 
Other (Please specify)
 
 
 
 
What is your medical specialty?
 
Anesthesiology
 
Internal medicine
 
Pathology
 
Surgery
 
Other (Please specify)
 
 
 
 
In the hospital’s organizational chart, which department has oversight of the PBM program?
 
Anesthesia
 
Blood bank
 
Nursing
 
Quality Management
 
Surgery
 
Other (Please specify)
 
 
 
 
Please select which of the following quality indicators your facility monitors. You may choose more than one.
 
Percentage of patients with a signed consent.
 
Percentage of RBC transfusions with a pre-transfusion hemoglobin or hematocrit result available and clinical indication documented.
 
Percentage of plasma transfusions with pre-transfusion laboratory testing and clinical indication documented.
 
Percentage of platelet transfusions with pre-transfusion platelet testing and clinical indication documented.
 
Percentage of transfused blood units/doses with documentation for all of the following: Patient identification and transfusion order confirmed prior to the initiation of transfusion and documentation of date and time of patient vitals such as blood pressure, pulse and temperature recorded pre, during and post transfusion.
 
Percentage of patients with documentation of preoperative anemia screening 14 - 45 days before Anesthesia Start Date (elective surgeries).
 
Percentage of patients with documentation of preoperative type and screen or type and crossmatch completed prior to Anesthesia Start Time.
 
Other (Please specify)

 
 
 
Enter the percentages of the quality indicators that your facility monitors for last year (2015)
   
__ Percentage of patients with a signed consent.
   
__ Percentage of RBC units (bags) with pre-transfusion hemoglobin or hematocrit result and clinical indication documented.
   
__ Percentage of plasma units (bags) with pre-transfusion laboratory testing and clinical indication documented.
   
__ Percentage of platelet doses with pre-transfusion platelet testing and clinical indication documented.
   
__ Percentage of transfused blood units/doses (bags) with documentation for all of the following:
   
o patient identification and transfusion order (or Blood ID Number) confirmed prior to the initiation of transfusion
   
o date and time of transfusion blood pressure, pulse and temperature recorded pre, during and post transfusion
   
__ Percentage of patients with documentation of preoperative anemia screening 14 - 45 days before Anesthesia Start Date (elective surgeries)
   
__ Percentage of patients with documentation of preoperative type and screen or type and crossmatch completed prior to Anesthesia Start Time
   
 
 
 
Please rank (1-3) the following in order of interest:
Skiing
Snowboarding
Biking
 
 
 
Rank in order of importance to your facility the quality indicators chosen in question 6 (1 is most important).