Alternative Approaches to Human Blood Resources in Clinical Practice

Alternative Approaches to Human Blood Resources in Clinical Practice

Author: Cees Smit Sibinga

Publisher: Springer Science & Business Media

Published: 1998-09-30

Total Pages: 280

ISBN-13: 9780792383055

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Currently blood is a volatile issue. The safety of blood and the quantification of transfusion risks have been dominant themes that have stimulated the development of alternative approaches in this rapidly developing area. In clinical medicine conventional blood and its components are used in supportive therapies dependent on the choice of apparent uncritical trigger factors. A compounding factor is depth of prospective clinical trials for evidence. Such trials in critical care areas would be of enormous value, not only in recording adverse effects and under-transfusion, but also indicating the value of decision analysis and cost-effectiveness in transfusion practice. Alternative approaches include the use of cytokines, growth factors, humanised monoclonal antibodies, recombinant plasma factors, and buffy coat derived natural human interferons. These are being increasingly implemented in the clinic. Solutions for oxygen transport are being developed and fibrinogen coated microcapsules are being investigated for thrombocytopenia. In surgical patients, various crystalloid and colloid combinations are explored as volume replacements. To avoid allogeneic transfusions, beneficial blood saving methods include various strategies, such as autologous deposits, normovolemic haemodilution and various agents including aprotinin, tranecamic acid, desmopressin and erythropoietin, but their use in hospital shows considerable variations. That umbilical cord blood could be a significant source of allogeneic stem cells in related and unrelated transplantation is illustrated by the increasing number of cord blood banks in Europe and elsewhere. Future blood resources are likely to face several challenges: immediate challenges relate to increased regulatory and political oversights; intermediate solutions would offer some improvements in public health and alleviate public fear but probably not address the economic challenges thrust upon the medical care system. As we approach the year 2000, the major concerns about transfusion medicine remain its logistics, safety and effectiveness. This theme is presented in the proceedings of the 22nd International Symposium on Blood Transfusion, developed in 21 up-to-date topics, collected and discussed in four sections. This book will be of timely value to students, professionals and all others interested or involved in the field of transfusion medicine, whether clinical or related.


Improving Healthcare Quality in Europe Characteristics, Effectiveness and Implementation of Different Strategies

Improving Healthcare Quality in Europe Characteristics, Effectiveness and Implementation of Different Strategies

Author: OECD

Publisher: OECD Publishing

Published: 2019-10-17

Total Pages: 447

ISBN-13: 9264805907

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This volume, developed by the Observatory together with OECD, provides an overall conceptual framework for understanding and applying strategies aimed at improving quality of care. Crucially, it summarizes available evidence on different quality strategies and provides recommendations for their implementation. This book is intended to help policy-makers to understand concepts of quality and to support them to evaluate single strategies and combinations of strategies.


Evidence-Based Medicine and the Changing Nature of Health Care

Evidence-Based Medicine and the Changing Nature of Health Care

Author: Institute of Medicine

Publisher: National Academies Press

Published: 2008-09-06

Total Pages: 202

ISBN-13: 0309113695

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Drawing on the work of the Roundtable on Evidence-Based Medicine, the 2007 IOM Annual Meeting assessed some of the rapidly occurring changes in health care related to new diagnostic and treatment tools, emerging genetic insights, the developments in information technology, and healthcare costs, and discussed the need for a stronger focus on evidence to ensure that the promise of scientific discovery and technological innovation is efficiently captured to provide the right care for the right patient at the right time. As new discoveries continue to expand the universe of medical interventions, treatments, and methods of care, the need for a more systematic approach to evidence development and application becomes increasingly critical. Without better information about the effectiveness of different treatment options, the resulting uncertainty can lead to the delivery of services that may be unnecessary, unproven, or even harmful. Improving the evidence-base for medicine holds great potential to increase the quality and efficiency of medical care. The Annual Meeting, held on October 8, 2007, brought together many of the nation's leading authorities on various aspects of the issues - both challenges and opportunities - to present their perspectives and engage in discussion with the IOM membership.


Patient Blood Management

Patient Blood Management

Author: Hans Gombotz

Publisher: Thieme

Published: 2015-11-10

Total Pages: 443

ISBN-13: 3132004510

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Patient Blood Management (PBM) is an innovative clinical concept that aims to reduce the need for allogenic blood transfusions, cut health-care costs, and avert or correct the risk factors related to blood transfusion, thus minimizing the rate of side effects and complications. This comprehensive hands-on volume offers a three-point approach for the implementation of PBM to improve patient outcome, focusing on how to prevent or treat anemia, reduce blood loss, and increase anemia tolerance. The book also goes beyond preoperative PBM, with detailed accounts of coagulation disorder management and the administration of coagulation products and platelet concentrates. Special Features: Presents a clear three-pillar strategy for the application of PBM: diagnosis and treatment of anemia, reduction of peri-interventional blood loss, and optimization of the tolerance to anemia in the everyday clinical setting Covers issues such as PBM during surgery, requirements for modern transfusion medicine, ordering blood products, the role of pre-anesthesia clinics, benchmarking processes, and potential implications of PBM in the public health sector Overview of research in PBM including landmark studies and current clinical trials Boxes in each chapter highlighting key information, core statements, and summaries A multidisciplinary and international team of contributors experienced in PBM Patient Blood Management is a guide for clinicians and residents whose patients are at risk for anemia, coagulation disorders, or severe blood loss. Anesthesiologists, surgeons, and specialists involved in the use of blood and blood products can use the book for quick reference or to learn more about a leading-edge concept for optimizing patient safety and improving outcome.


Beyond the HIPAA Privacy Rule

Beyond the HIPAA Privacy Rule

Author: Institute of Medicine

Publisher: National Academies Press

Published: 2009-03-24

Total Pages: 334

ISBN-13: 0309124999

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In the realm of health care, privacy protections are needed to preserve patients' dignity and prevent possible harms. Ten years ago, to address these concerns as well as set guidelines for ethical health research, Congress called for a set of federal standards now known as the HIPAA Privacy Rule. In its 2009 report, Beyond the HIPAA Privacy Rule: Enhancing Privacy, Improving Health Through Research, the Institute of Medicine's Committee on Health Research and the Privacy of Health Information concludes that the HIPAA Privacy Rule does not protect privacy as well as it should, and that it impedes important health research.


Finding What Works in Health Care

Finding What Works in Health Care

Author: Institute of Medicine

Publisher: National Academies Press

Published: 2011-07-20

Total Pages: 267

ISBN-13: 0309164257

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Healthcare decision makers in search of reliable information that compares health interventions increasingly turn to systematic reviews for the best summary of the evidence. Systematic reviews identify, select, assess, and synthesize the findings of similar but separate studies, and can help clarify what is known and not known about the potential benefits and harms of drugs, devices, and other healthcare services. Systematic reviews can be helpful for clinicians who want to integrate research findings into their daily practices, for patients to make well-informed choices about their own care, for professional medical societies and other organizations that develop clinical practice guidelines. Too often systematic reviews are of uncertain or poor quality. There are no universally accepted standards for developing systematic reviews leading to variability in how conflicts of interest and biases are handled, how evidence is appraised, and the overall scientific rigor of the process. In Finding What Works in Health Care the Institute of Medicine (IOM) recommends 21 standards for developing high-quality systematic reviews of comparative effectiveness research. The standards address the entire systematic review process from the initial steps of formulating the topic and building the review team to producing a detailed final report that synthesizes what the evidence shows and where knowledge gaps remain. Finding What Works in Health Care also proposes a framework for improving the quality of the science underpinning systematic reviews. This book will serve as a vital resource for both sponsors and producers of systematic reviews of comparative effectiveness research.


Disease Control Priorities in Developing Countries

Disease Control Priorities in Developing Countries

Author: Dean T. Jamison

Publisher: World Bank Publications

Published: 2006-04-02

Total Pages: 1449

ISBN-13: 0821361805

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Based on careful analysis of burden of disease and the costs ofinterventions, this second edition of 'Disease Control Priorities in Developing Countries, 2nd edition' highlights achievable priorities; measures progresstoward providing efficient, equitable care; promotes cost-effectiveinterventions to targeted populations; and encourages integrated effortsto optimize health. Nearly 500 experts - scientists, epidemiologists, health economists,academicians, and public health practitioners - from around the worldcontributed to the data sources and methodologies, and identifiedchallenges and priorities, resulting in this integrated, comprehensivereference volume on the state of health in developing countries.


Engineering a Learning Healthcare System

Engineering a Learning Healthcare System

Author: National Academy of Engineering

Publisher: National Academies Press

Published: 2011-07-14

Total Pages: 340

ISBN-13: 0309120640

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Improving our nation's healthcare system is a challenge which, because of its scale and complexity, requires a creative approach and input from many different fields of expertise. Lessons from engineering have the potential to improve both the efficiency and quality of healthcare delivery. The fundamental notion of a high-performing healthcare system-one that increasingly is more effective, more efficient, safer, and higher quality-is rooted in continuous improvement principles that medicine shares with engineering. As part of its Learning Health System series of workshops, the Institute of Medicine's Roundtable on Value and Science-Driven Health Care and the National Academy of Engineering, hosted a workshop on lessons from systems and operations engineering that could be applied to health care. Building on previous work done in this area the workshop convened leading engineering practitioners, health professionals, and scholars to explore how the field might learn from and apply systems engineering principles in the design of a learning healthcare system. Engineering a Learning Healthcare System: A Look at the Future: Workshop Summary focuses on current major healthcare system challenges and what the field of engineering has to offer in the redesign of the system toward a learning healthcare system.


Molecular Biology in Blood Transfusion

Molecular Biology in Blood Transfusion

Author: Cees Smit Sibinga

Publisher: Springer Science & Business Media

Published: 2000-09-30

Total Pages: 304

ISBN-13: 9780792365341

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The international symposia on blood transfusion in Groningen have taken place without interruption since 1976. Each year Dr. Smit-Sibinga and his team have not only organized a meeting on timely topics in blood transfusion, but also succeeded in attracting prominent chairmen and speakers. The subject of the 24th Symposium was Molecular Biology in Blood Transfusion and it was chaired by Dr. Harvey G. Klein, National Institutes of Health, USA. In this book of proceedings an extraordinary range of subjects is covered, including diagnostic aspects, virology, quality control, cell and protein processing as well as a section on new horizons in clinical medicine.