The University of Texas MD Anderson Cancer Center, one of the world’s largest comprehensive cancer centers, is one of seven exemplary implementation stories that Choosing Wisely plans to highlight monthly for the remainder of this year. These case studies will explain the problem, recount the solutions, including core interventions, and outline the challenges and keys to success. For the Houston-based cancer center, the issue resided in blood stewardship.
With high perioperative blood transfusion levels in gynecologic oncology, leaders from MD Anderson piloted an overuse reduction initiative, using the Choosing Wisely 2013 American Society of Hematology transfusions targets as guidelines.
Year-long data collection allowed researchers to build a convincing case about the need for a reduction initiative. Core interventions included clinician education, guidelines reminders in clinical order sets, physician champions and continuous monitoring of transfusion. Some of the challenges included securing buy-in from key players during initial project implementation phases, and flexible guidelines in existing order sets.
Read about the keys to success in the full case study here.