Strategic planning is necessary. Not every part of patient blood management can be implemented at once. Pick only one or no more than two initiatives to start. They should be those that have the best likelihood of being implemented.
One way to make a decision on what to begin working is to use a grid. List the initiatives on the left column. Going across, enter the column headings: personnel resources, equipment, training, degree of change and score. Using a 5 point scale where 1 is very difficult/costly, etc and 5 is very easy/less costly, etc. rate each initiative and resource using the scale. Multiply the numbers in each row to obtain a score. The ones with the highest scores are the most likely to succeed.
Initiatives | Personnel Resources | Equipment Costs | Training | Degree of Change | Score |
Stop using plasma for warfarin reversal | 4 | 1 | 3 | 2 | 24 |
Decrease iatrogenic blood loss | 2 | 3 | 2 | 2 | 24 |
Reduce blood use in XXX surgeries | 1 | 1 | 2 | 1 | 2 |
etc. | | | | | |
Ongoing tracking of performance measures provides information on whether interventions are working and where additional attention should be directed.
