Anaemia Management Workstream in Wales
Extensive evidence shows a link between blood transfusion and anaemia to poorer perioperative outcomes. The BHNOG Anaemia Workstream identified inconsistent approaches to anaemia across Wales, leading to a lack of equity in patient care. An All Wales group of pre-op anaemia leads has been established to develop a Perioperative Anaemia Pathway aiming for early identification of modifiable causes like iron deficiency. A centralized Anaemia Co-Ordinator will support pathway implementation at hospital levels to ensure standardized practices.
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Presentation Transcript
BHNOG Anaemia Management Workstream Workstream Lead: Dr Caroline Evans, Consultant Cardiothoracic Anaesthetist
Extensive evidence linking blood transfusion and anaemia to poorer outcomes perioperatively National Collaborative Audit NHSBT identified perioperative anaemia care across UK as poor NICE guidance NG24, NG138 Blood transfusion and Iron deficiency Two international consensus statements peer reviewed publications in Anaesthesia to promote perioperative optimisation (2018, 2019) BHNOG Anaemia Workstream has identified inconsistent approach to anaemia across Wales leading to lack of equity of care for patients Why Optimise Patients for Surgery?
Anaemia Workstream Established All Wales group of pre-op anaemia leads (POMS) covering each HB All hospitals shared local guidance to establish baseline practice and undertook a survey to collect data on baseline practice Developed All Wales Perioperative Anaemia Pathway Too allow early identification of modifiable causes of anaemia 80 % iron deficiency
Development of All Wales Perioperative Anaemia Pathway Approved by BHNOG in December 2021
Follow Up Survey A follow up survey was undertaken to assess compliance to the All Wales pathway WPOMS identified barriers to implementation including: test turnaround times the ability to review results staff/ facilities to provide IV iron
A minimal testing bundle of Haemoglobin (Hb), ferritin and/or Transferrin saturation (TSATS) was agreed by WPOMS & currently working with IT and pathology colleagues to establish standard test codes This standardised approach will support electronic data extraction for audit purposes thus making a perioperative anaemia pathway across Wales more achievable Centralised Anaemia Co-Ordinator to support pathway implementation at a hospital/HB level Survey Responses & Follow up Work https://gov.wales/sites/default/files/publications/2021-09/nhs- wales-blood-health- plan.pdealth%20and%20wellbeing%2C%20avoiding%20unnec essary%20intervention%202.
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