Patient Blood Management

Aishwarya Vishwanath

Medical School Class of 2020

Reflection

As a candidate for an M.D. with Distinction, I have been working on a quality improvement initiative since my first year of medical school. This project is a patient blood management initiative aiming to reduce avoidable transfusions administered to cardiovascular and thoracic surgery patients during intra- and post-operative phases of care. It revolves around the construction of an audit and feedback tool to provide relevant information to clinicians regarding their transfusion behavior so as to promote behavior change in the future.

Development of this tool involved detailed survey and interview of the clinicians, the surgeons, and anesthesiologists who would eventually use the instrument, regarding the factors most pertinent to their transfusion practice. Results from this survey indicated that risk-adjusted individual- and service line-level data regarding transfusion rate and hemoglobin level were most pertinent to transfusion practice. Based on these results, the Transfusion Dashboard was constructed to display such data longitudinally to provide clinicians with information about their transfusion behavior in comparison to that of their peers and service line on a quarterly basis.

To conclude, this work demonstrates that collaboration with clinicians is an important and effective step in the implementation of an audit and feedback system. Future directions involve implementation of this initiative and assessment of its effect on transfusion behavior.

Opportunities to learn valuable skills

The M.D. with Distinction in Quality Improvement and Patient Safety program provides students with countless opportunities to learn valuable skills for future patient care. The development and implementation of QI initiatives may appear intuitive at first glance, but in reality projects involve mastery of several tools to successfully promote a behavior change.

What is truly unique about this program, though, is that students do not simply learn these skills from lectures or reading, but are provided opportunities to spearhead projects impacting patient care from the beginning of their medical school career.

Gaining leadership skills

From this program, I have gained valuable leadership skills and the ability to work as a productive member of a multidisciplinary team. We also receive extensive individualized mentorship to ensure a productive learning environment to learn QI techniques and essential skills in scholarly writing. I have been able to submit abstracts about my project to several conferences both on the local and national scales, present my project to a large audience at a major professional society conference (the American Society of Anesthesiologists Annual Meeting), and have had my project be recognized and awarded on the national level by a major QI society (The Anesthesia Patient Safety Foundation).

These opportunities have allowed me to network with prominent individuals involved in QI from around the nation and world and gain skills that will allow me to conduct successful projects in residency and my future career. None of this would have been possible without the mentorship and opportunities provided by the M.D. with Distinction in QI program.

– Aishwarya Vishwanath, Medical School Class of 2020