Page 22 - ANZCP Gazette AUG 2023

Nine cardiac surgical sites across Australia and New Zealand routinely collect data for each case involving a perfusionist. This data covers all aspects of the patient’s surgical journey. Currently the dataset contains over 46,000 cases with around 330 data points per patient dating back to 2007
Data is harvested annually from each site, cleaned, and complied into three annual reports by the registry:
• A single site report showing data for that specific site over the years of participation.
• A multisite report showing comparative data across all sites for that year.
• An Executive summary containing summary data for that year for that year across all sites.
Sites disseminate these reports to a variety of stakeholder within their service. They contain a wealth of information. With these reports, sites can review their progress over the years, and can compare their performance with other sites and make improvements where necessary.
Furthermore, it’s a valuable way of identifying a ‘well performing’ site on a particular aspect who can share their secrets of success. Sharing knowledge drives improvement across the whole collaborative.
In time, data on these improvements is collected and reported leading to further opportunities for reflection & improvement.
Action 7.04 – Optimizing and conserving patients' own blood.
Action 7.04 documents the need for clinicians to use the blood and blood product processes to manage the need for, and minimising the inappropriate use of, blood and blood products by:
a) Optimising patients own red cell mass, haemoglobin, and iron stores.
b) Identifying and managing patients with or at risk of bleeding.
c) Determining the clinical need for blood and blood products and related risks.
As perfusionists and surgical teams, we use many strategies to optimise and conserve our patient's blood. Yet how is compliance to these strategies and any resultant improvements measured? How would a cardiac centre know if they were ‘good’ at blood management? How does it compare with other sites?
This paper reviews three blood management strategies to showcase how the ANZCPR registry adds value:
1. Minimising priming volumes
Minimizing priming volumes has been a patient blood management focus for perfusionists in recent years. It is also an STS class 1 level B recommendation. The ANZCPR has been collecting data on priming volumes for years.
Figure 1 represents the average net prime volumes for the whole collaborative over time. The downward trend is evident. In 2008 the average prime volume was 1650ml today it’s 1100ml.
Figure 2 represents a single site view of its net priming volumes over time. Figure 3 is the 2021 snapshot of current prime volumes across all participating sites. This volume ranges from about 550ml at site 3 up to site 1 with 1300ml, with the red line indicating the average at 1100ml.
Fig 1 Multisite
Fig 2 Single site
Fig 3 Multisite 2021
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