OPTIMAL USE OF BLOOD (VOK PROGRAMME)

General

All currently available data on the clinical use of blood and blood components indicate a wide variation in indications and dosage both across countries (Sirchia et al. 1994) and among hospitals within a country (see e.g. Capraro 2001). However, attempts to optimise and standardise blood use have not always succeeded.

The Programme for Optimal Use of Blood (VOK Programme) is a collaborative effort between the Finnish Red Cross Blood Service and major Finnish hospitals to provide commensurate data on blood use in the participating organisations. So far, all five teaching hospitals in Finland and five other major hospitals have joined the Programme, and the VOK Database now covers about 68% of the consumption of blood components in Finland (year 2007).

Data for the VOK Database are collected from hospitals' administrative, laboratory, blood bank and operating theatre registers as well as from the Blood Service's Blood Donor Registry. Patient identifications are encrypted in the Database and cannot be traced back to the individual patient. The Database includes information about diagnoses, procedures, laboratory results and the transfused blood components. The Database allows analysis of differences in blood use and evaluation of clinical practices. The participating hospitals are also able to conduct specific analyses of data pertaining to their own organisation. The ultimate aim of the VOK Programme is to improve patient safety and outcomes of patient care. (Palo et al. 2006).

Reports

The VOK Database currently includes data from 2002 to 2007. Data are collected twice a year, and reports of recent statistics are regularly published on the Internet. The reports are designed to compare blood use in participating hospitals and to illustrate changes from previous reports. The reports also include graphics, which can be viewed by clicking the graph symbol. As a result of ongoing changes in hospital data systems, information on some hospitals may be lacking for a particular period. Naturally there will also be no data for the first years in case of hospitals that have only recently joined the Programme.

VOK report: Use of blood components

VOK report: Use of red cells in primary hip replacement surgery and childbirth

Benchmarking

Blood Service organises benchmarking events for clinical professionals involved with blood use in different hospitals. The following medical specialities have so far been dealt with: orthopaedics, gynaecology, haematology and heart surgery. The benchmarking events typically consist of presentation of specific VOK reports and, most importantly, group discussions of differences in practices among hospitals. Lectures are given by the participants as well as invited experts. Experiences from the events are encouraging, and the benchmarking discussions have led to adoption of best practices in several cases. This is also reflected in VOK reports, showing reduction of differences in blood use.

VOK Benchmarking Event:
(31kB) Gynaecology and obstetrics (15 November 2004)

VOK Review Meeting:
(30kB) Gynaecology and obstetrics (31 March 2006)

Literature

Capraro, L. Transfusion practices in elective surgical procedures in Finnish hospitals. Dissertation. University of Helsinki, Helsinki, 2001.
http://ethesis.helsinki.fi/en/

Palo, R., Ali-Melkkilä, T., Hanhela, R., Jäntti, V., Krusius, T., Leppänen, E., Mahlamäki, E.K., Perhoniemi, V., Rajamäki, A., Rautonen, J., Salmenperä, M., Salo, H., Salonen, I., Savolainen, E-R., Sjövall, S., Suistomaa, M., Syrjälä. M., Tienhaara, A., Vähämurto, M., Mäki, T. Development of permanent national register of blood component use utilizing electronic hospital information systems. Vox Sanguinis 2006;91:140-147.

Sirchia, G., Giovanetti, A.M., Mc Clelland, B., Fracchia G.N. (eds.). Safe and good use of blood in surgery (SANGUIS). Use of blood products and artificial colloids in 43 European hospitals. Report No. EUR 15398 EN, Office for Official Publications of the European Communities, Brussels/Luxembourg, 1994.