Blood transfusions decrease by 34%, patient safety improves

Lakeland Healthcare, St. Joseph, Michigan

Lakeland HealthCare is a not-for-profit, community-owned system of care serving southwest Michigan. The system includes three hospitals; walk-in clinics; long-term and home care; and laboratory, radiology and rehabilitation services. Lakeland received the VHA Leadership Award for Clinical Excellence for its patient care in its intensive care units.

lakeland health

At a Glance

In October 2005, Lakeland HealthCare was charged with implementing a challenging blood utilization initiative to decrease blood transfusions throughout the organization. “Minimizing blood transfusion is safer for patients because you minimize the risk of transmitted infections,” says Kourosh Baghelai, MD, Lakeland’s chief of cardiothoracic surgery. “But more importantly, every unit of blood transfused causes a depression of the immune system — which increases the risk of infection and other immunologic reactions to the transfusion. Cost is also a factor because it’s expensive to acquire and administer blood.”

The organization looked to VHA-contracted supplier SpecialtyCare for guidance. Lakeland has relied on SpecialtyCare’s perfusion services since 1984, both because of its quality and continuity (the hospital has had the same chief perfusionist, Dean Lindemann, for more than 20 years) and its status as a VHAcontracted supplier.

“The fact that SpecialtyCare is a VHA supplier plays a large role in our decision-making process for each continued contract,” says Al Martinez, Lakeland’s cardiovascular outcomes coordinator. “And it’s always good to know that VHA is there if we need them.”

Valuable Data and Expert Resources

SpecialtyCare’s Clinical Quality Improvement Program is vital to Lakeland’s success, providing information monthly that is used to guide hospital process improvements and reveal variations in patient care as they occur, allowing the staff to provide an efficient and timely response. “Because of SpecialtyCare’s data, we can concurrently react to our blood utilization issues instead of waiting 90 days for Society of Thoracic Surgeons’ reports or to run a query through our blood bank,” says Martinez. “Dean keeps me abreast of any blood utilization issues so that we can instantly identify the source of the problem.”

SpecialtyCare’s perfusionists are expert resources for Lakeland’s blood conservation team, often sharing information that they learn from SpecialtyCare’s leading-edge online staff education programs, SpecialtyCare University, and other SpecialtyCare resources to help improve quality of care. For example, Martinez worked directly with Lindemann to implement a preoperative admission protocol for patients at high risk for post-operative renal failure, based on information that Lindemann learned at a SpecialtyCare perfusion-related meeting. “We now pre-admit those patients for IV hydration the night before surgery, and they’ve shown a decrease in postoperative renal failure as a result,” says Martinez.

“Our morbidity and mortality rates are significantly less than national benchmarks, which speaks to the talent, skills and knowledge of SpecialtyCare’s perfusionists,” — Kourosh Baghelai, MD, Chief of Cardiothoracic Surgery

Instrumental in Our Success

Lakeland transfused an average of 34% fewer red blood cell units per procedure when compared to SpecialtyCare’s national benchmark of 150 other adult open-heart programs in the U.S. in 2008. SpecialtyCare’s Clinical Quality Improvement Program helped the organization identify opportunities to minimize transfusion requirements and document successful clinical practice changes.

Lakeland also consistently maintained a lower than average intraoperative glucose level (161 mg/dL) as compared to SpecialtyCare’s benchmarks — a measure proven to reduce mortality, morbidity (i.e. infection) and length of stay.

The health care organization’s use of post-operative intra-aortic balloon pumps has decreased to nearly zero in the last two years. “Our perfusion efforts ensure that the heart is optimally preserved,” says Baghelai. “No matter how sick the patient or how complex the operation, we’ve achieved excellent protection of the heart. And our morbidity and mortality rates are significantly less than national benchmarks, which speaks to the talent, skills and knowledge of SpecialtyCare’s perfusionists.”

Lakeland’s Heart Center has achieved Center of Excellence status from the Centers for Medicare and Medicaid Services and has been designated a Blue Distinction Center for Cardiac Care from Blue Cross/Blue Shield of Michigan – an achievement that SpecialtyCare’s perfusionists helped make possible. “We think the world of Dean, SpecialtyCare and the services they’ve provided,” says Martinez.

SpecialtyCare’s perfusionists possess all the qualities Baghelai requires in such an integral part of his surgical team. “Number one is their perfect availability,” he says. “The nature of our business is unpredictable, and they’ve been able to provide excellent coverage. Second is the quality of the perfusion, which comes from the talent and quality of personnel, as well as their modern equipment. This is a complex field, and SpecialtyCare has provided excellent, safe and effective perfusion.”



“The level of professionalism that SpecialtyCare and its perfusionists bring is magnificent, and they’ve been very instrumental in our success.”

Looking Toward the Future

Emond says that SpecialtyCare’s perfusionists have integrated well with Morristown Memorial’s cardiac team. “We’ve been very pleased with the services that SpecialtyCare has provided, and we find them to be very collaborative — and together, we’ve been able to continue and improve upon the services we provide.”

While Brown is also pleased with the team’s collaborative achievements thus far, he looks toward an even more positive future. “SpecialtyCare has worked very well with the institution in keeping costs down. They’ve been an asset for us as we’ve moved forward with blood management, and an even bigger asset with our heart failure and LVAD patients. I’m expecting even greater things going forward.”

“Partnering With You”

To bring highly trained clinicians and specialized services to your hospital.

About Specialty Care: SpecialtyCare brings the benefits of outsourced clinical services to hospitals across the country. We hire and train highly qualified clinicians — perfusionists, clinical technicians, surgical assistants and neurological monitoring technologists — who in turn provide exemplary service to our clients. The result: lower costs, better outcomes and fewer administrative headaches.