Maximum surgical blood ordering schedule improves blood utilization in elective surgeries :An experience in Faghihi hospital, Shiraz, Iran

Abstract Background and Objectives Over-ordering of blood before operation can cause unnecessary cross matches, blood bank staff overload, blood unit wastages due to outdating, and increase hospital costs. So, we aimed to survey the efficacy of MSBOS on blood utilization in Faghihi Hospital, Shiraz, Iran.   Materials and Methods This cross sectional study was conducted over a three month period in 2019 and 2020 (before and after MSBOS establishment) in Faghihi Hospital, Shiraz, Iran. The education class was held for surgeons to order blood according to MSBOS. The frequency of cross matches, transfused blood units, and the cross match to transfusion ratio were compared before and after MSBOS establishment by comparison of proportions by MedCalc software in the elective surgical ward.   Results The cross match to transfusion ratio significantly decreased after MSBOS establishment (3.97 to 1.46). The transfusion index and transfusion probability increased significantly after MSBOS establishment (25.2% to 63.6%, 24.7% to 59.4%)) p < 0.001). The cross match rates also decreased (51.13%). The cross match costs also decreased from 293898528 Rials (Iranian currency) to 143626560.   Conclusions  In this study, the cross match to transfusion ratio decreased significantly after MSBOS establishment which shows the effectiveness of MSBOS on rational blood use. So, the education of surgeons and emphasis on blood ordering according to MSOBS can improve blood usage.