The effect of maximum surgical blood ordering on blood utilization in elective surgeries in 23 hospitals of Shiraz, Iran

Abstract Background and Objectives Over ordering of blood in elective surgical procedures due to fear of bleeding and unavailability of sufficient blood can cause blood wastage and increase blood bank expenses. This study compared blood ordering and utilization after the introduction of maximum surgical blood ordering (MSBOS) in elective surgeries.   Materials and Methods This cross sectional study was carried out on one third of Shiraz hospitals (23 hospitals) between 2016 and 2017, Shiraz, Iran. The localized MSOBs was sent as a guideline to the hospitals. The mean number of blood requests, blood utilization, cross matches, cross match to transfusion ratio, and cross match expenses before and after implementing of MSBOS were compared with paired t test by SPSS-21 software.   Results The cross match to transfusion ratio was decreased after implementing MSOBS (2.36 to 1.6) (p < 0.001). In addition, the mean numbers of blood usage and cross matches were also decreased after implementing of MSBOS (13.2%, 42.9%). The cost of  preparing blood and cross matches also decreased (7.67%, 43%).   Conclusions  Implementation of MSBOS created a significant reduction in transfusion ordering and providing blood in emergencies. Updating of physician’s knowledge, the revision of MSOBS according to blood usage in the hospitals must be performed for optimal blood management.