BMC’s can be established; locally, for clusters of healthcare providers, across affiliated organisations, or for private health establishments, although many BMC are based at hospital level. BMC are also known by other names, which represent their standing, alignment and key aims. For example, ‘Hospital Transfusion Committee’, ‘Blood Utilisation Committee’, ‘Blood User Groups’ to name a few.
The direct responsibility of the committee may vary. Some BMC’s will be directly responsible for the whole transfusion chain from donor to patient whilst others may be responsible for the activities within the hospital setting.
There are countries where the safety and responsibility of transfusion is governed by law and government regulated (2, 3, 4).
BMCs are essential to transfusion safety, and appropriate use of blood components. Liumbruno and Rafanelli (5) indicate that according to Italian legislation, a functional BMC should have a major impact on local rates of inappropriate transfusion, as well as on clinical governance, haemovigilance and safety of the transfusion medicine process. Blood Management/Hospital Transfusion Committees and Transfusion Teams, if properly constituted and adequately resourced, can be a powerful force for improving transfusion safety (6). The success of the BMC in improving blood management and reducing inappropriate use of blood have been reported (8), for example by developing local transfusion policies that was followed by a reduction in red cell transfusions after they were introduced (1).
Not only can a functional BMC have a major impact on local rates of inappropriate transfusion (9) they can also be seen as the hub of PBM activity. PBM will require engagement with end-users, managers and other key stakeholders all of whom should be represented at BMCs. To implement PBM initiatives the first point of presentation may be at a BMC meeting for engagement and approval as well as building partnerships for implementation. The BMC is also an ideal forum to present progress and final results (10, 11). In some countries, for large projects approval is sought of the hospital medical board (representatives of all medical staff). In England, following the NHS England endorsed PBM recommendations, 94 per cent of Trusts have PBM initiatives included on the standard BMC agenda whilst six per cent have a separate working group or PBM agenda (12).
In recent years BMC’s are have become more active in some countries and are taking charge of transfusion matters, even in situations where there is a lack of support from management bodies. However; without adequate support, resources and real authority the BMC will not be fully functional nor have a strong enough impact on transfusion practice (5).
BMCs need to remain flexible and continue to influence practice in clinical areas. As new evidence becomes available, they should advise clinician’s on the best practice for the use of blood and blood components to improve outcomes and save patient lives. Below are some resources, which will support BMCs.
If you have others please contact the ISBT office to get these uploaded.
- Ontario Regional Blood Coordinating Network, Toolkits, Transfusion Committee: Ontario Regional Blood Coordinating Network 2020
- Australian Red Cross LifeBlood, Transfusion Committees Resources Australian Red Cross LifeBlood 2020
- NHS Blood and Transplant, Transfusion Team Resources, Resources for Transfusion Practitioners, Transfusion Laboratory Managers and Hospital Transfusion Committees NHS Blood and Transplant 2020
- Supporting Patient Blood Management (PBM) in the EU. A Practical Implementation Guide for Hospitals. EUROPEAN COMMISSION, Directorate-General for Health and Food Safety 2020
- Developing a National Policy and Guidelines on the Clinical Use of Blood World Health Organisation WHO World Health Organisation WHO 2001
- German Transfusion Law: Gesetz zur Regelung des Transfusionswesens (Transfusionsgesetz - TFG) Bundesministerium der Justiz und fur Verbraucherschutz 1998
- Querschnitts-Leitlinien (BÄK) zur Therapie mit Blutkomponenten und Plasmaderivaten – Gesamtnovelle 2020 The Board of the German Medical Association on the Recommendation of the Scientific Advisory Board (Bundesärztekammer) (Bundesärztekammer) 2020
- Richtlinien zur Gewinnung von Blut und Blutbestandteilen und zur Anwendung von Blutprodukten (Richtlinie Hämotherapie), GesamtnovelleDie Bundesärztekammer 2017
- Appropriateness of blood transfusion and physicians’ education: a continuous challenge for Hospital Transfusion Committees? Liumbruno, GM. and Rafanelli, D. Blood Transfuse. Editorial. 10. Pp1-3 2012
- Reducing adverse events in blood transfusion Stainsby, D., Russell, J., Cohen, H. and Lilleyman J. British Journal of Haematology. 131. Pp8-12. 2005
- Building better hospital transfusion committees for Ontario Owens, W., Gagliardi, K. and Lauzon, D. Transfusion and Apheresis Science. 46. 323-327. Pp 2012
- Can hospital transfusion committees change transfusion practice? Torella, F., Haynes, SL., Bennett, J., Sewell, D. and McCollum, CN. Journal of The Royal Society of Medicine. Vol 95. Pp 450 -452. 2002
- The role of hospital transfusion committees in blood product conservation. Haynes, SL. And Torella, F. Transfus Med Rev. 18 (2). Pp 93-104. 2004
- The Hospital Transfusion Committee. Guidelines for Improving Practice Grindon, AJ., Tomasulo, PS., Bergin, JJ., Klein, HG., Miller, JD. And Mintz, PD. JAMA. 253 (4). Pp 540-543. 1985
- The hospital transfusion committee: a step towards improved quality assurance. Calder, L. and Woodfield G. N Z Med J. 104 (921). Pp 427-9. 1991
- 2018 Survey of Patient Blood Management NHS Blood and Transplant 2018
- An international survey on the role of the hospital transfusion committee Yazer, MH, Lozana M, Fung M, et al. Transfusion 2017;57(5):1280-1287