An ongoing UF Health Shands Patient Blood Management initiative brings preoperative anemia screening and treatment to cardiac surgical care.
A quality project implemented in the Division of Cardiovascular Surgery in the University of Florida Department of Surgery aims to standardize preoperative anemia testing as part of ongoing efforts by the UF Health Shands Patient Blood Management program.
Anemia, or low levels of measurable hemoglobin, affects between 30% and 50% of patients undergoing cardiac surgery in the United States, and early identification can lead to reduced needs for intraoperative blood transfusions and, by extension, better outcomes for patients.
“We’ve always screened patients identified as high risk for intraoperative bleeding or who cannot have transfusions during procedures,” said Thomas Beaver, M.D., M.P.H., the Grant and Shirle Herron Chair and professor and chief of the Division of Cardiovascular Surgery. “Working with the Patient Blood Management team gives us the chance to open these screenings up for everybody without impacting the speed at which we’re able to provide treatment.”
Patients who are identified as anemic through noninvasive screening are referred to colleagues in hematology for further evaluation to discuss potential treatment options.
“The most common intervention we do is intravenous iron therapy,” said Marc Zumberg, M.D., a professor in the UF Department of Medicine’s Division of Hematology and Oncology. “But patients presenting with kidney disease, B12 deficiency or other less common causes of anemia can also be given targeted treatments to improve surgical outcomes.”
Zumberg, who is the associate director of the UF Health Shands Hospital Patient Blood Management initiative and chair of the UF Health Transfusion Committee, said the program is poised for significant growth.
“We’ve piloted our preoperative anemia algorithms in several clinics and have done a great job optimizing the process for referring surgeons to get screenings completed,” he said.
That interdisciplinary aspect is no small part of why the program works.
“Multidisciplinary care is what separates an academic health center like ours from other institutions,” Zumberg said. “We have significant expertise across many different services, from hematology to anesthesia to transfusion medicine and beyond, and we can leverage that depth to make significant quality improvements for our patients.”
Beaver credits Thorsten Haas, M.D., a professor in the UF Department of Anesthesiology and the director of the Patient Blood Management program, for driving the initiative.
Haas is excited to review the data coming out of the project, which he hopes will further encourage surgical services at UF Health to collaborate with the Patient Blood Management program.
“The sound analysis of outcome data can be one of the most powerful motivators,” Haas said. “Seeing in-house improvements to patient quality really drives home the impact of programs like ours.”
Beaver said anemia screening compliance has significantly improved since implementing the program, and his clinic has set a goal of 90% or better compliance by January 2027.
Future improvements to the program include will further streamlining the referral process from the clinic to hematology labs as a routine part of the preoperative evaluation.