While some of the basic ideas and concepts constituting what is known today as bloodless medicine have been around for centuries, the idea of a set of medical and surgical techniques aimed specifically at eliminating the necessity of blood transfusions has only been around since the 1960s. The idea was spurred mainly by Jehovah’s Witnesses, who became outspoken about their opposition to blood transfusions in the beginning of the 20th century.Physicians were initially skeptical about performing complex surgeries and operations without using blood transfusions. However, after decades of campaigning and even federal court cases, Witnesses won the right to be treated without blood transfusions.The early practitioners of bloodless medicine worked almost exclusively with Jehovah’s Witnesses to perform bloodless surgery. In many cases, doctors, nurses and healthcare professionals noticed the results from bloodless operations were actually better than similar operations where a transfusion had been performed. Benefits included quicker recovery times and lower costs. Eventually, these physicians began publishing their results, noting the advantages to these bloodless procedures over traditional blood transfusions. They also explained these benefits to other physicians and encouraged them to adopt the practices with non-Witness patients.After surgeons in New Orleans and Los Angeles gained attention for performing bloodless open heart surgeries (or “bloodless hearts”), the popularity of bloodless surgery techniques with physicians began to spread around the world. By the late 1970s, bloodless medicine was available at healthcare systems in the U.S., Canada, Europe and India.Not long thereafter, the public began to take notice as well. Concerns about the human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) led to people beginning to question where the source of donated blood used in transfusions was coming from. Fear over contracting AIDS through contaminated donor blood led to large numbers of non-Witness patients requesting bloodless surgeries.Physicians have generally welcomed the increased demand for bloodless surgery in the modern medical climate. Bloodless surgeries have a number of specific advantages to both the patient and surgeon, as well as benefits to the hospital systems offering bloodless surgery. Because more than 50% of surgeries in the U.S. are pre-planned or elective surgeries, many doctors are actually encouraging their patients to consider blood transfusion alternatives.Why do doctors and healthcare professionals like bloodless surgery methods? There are a number of specific reasons why a particular doctor or healthcare system might choose to offer bloodless medicine program. However, there are two huge advantages that benefit the doctor, the patient and the healthcare system.1.) Bloodless Surgeries have fewer complications -Fewer complications mean fewer post-surgery procedures and a quicker recovery time. This is obviously good for patients, but it is good for physicians as well. It frees up more of their time and lessens the likelihood that they could lose a patient in surgery.2.) Bloodless surgery is more cost effective -A blood transfusion can cost anywhere from $500-1000, depending on the amount of units needed, the length of the hospital stay, administrative costs, and other circumstances. According to a study by a national U.S. news publication, the total bill for blood transfusions is somewhere between $1 and $2 billion annually. After insurance, the bulk of these charges does not deflect to the patients and is absorbed by the doctors and hospitals. Still, the process is by no means cheap for the patient.Cost-cutting is currently a priority for both patients and healthcare systems. Bloodless surgeries are far more cost effective, benefiting the patient, the individual doctors and the healthcare systems that employ them. For more information about bloodless surgery, contact your local healthcare provider.
For the past 20 years, UW Medicine has received top ratings from U.S. News & World Report for its clinical, education and research programs. However, even one of the nation’s leading academic healthcare systems feels the current economic strain and pressure of national healthcare reform. It can be a challenge to improve healthcare quality, safety and access while also controlling and reducing costs.Paul G. Ramsey, MD, CEO of UW Medicine, executive vice president for medical affairs and dean of the school of medicine at the University of Washington in Seattle, discusses UW Medicine’s current goals as well as the system’s “secrets for success” in the current healthcare climate – measurements and metrics, teamwork, hard work and a clear vision for the future.Question: What are UW Medicine’s current goals?Dr. Ramsey: We are in a very exciting and challenging time in medicine. UW Medicine’s primary goals relate to our mission of improving health for all people. It is important for UW Medicine, as a leading healthcare and academic system, to remain focused on improving the quality and safety of care and the overall services to patients and their families. At the same time, substantially controlling and reducing costs in the same areas are important.Our goals this year encompass our mission of improving health in the work we do – in research to discover new ways to improve health, in our clinical programs by offering the very best care for our patients, and in our education and training programs designed to prepare the next generation of health and science professionals.Q: How do you go about achieving your goals?PR: As we focus on improving quality and safety in patient care while improving our services, we use measurement tools to assess where we are now, to monitor our progress, and to set goals for making improvements for the coming year.Our research, supported primarily by grants, is oriented toward improving health. For educational programs, we establish measures and benchmarks to track outcomes, such as where our medical students and residents choose to practice after training, what percentage go into primary care, and how many students and residents choose practice settings that care for underserved patient populations. Metrics and measurements help us identify and support effective programs and improve our outcomes.One excellent example of our use of measurement in clinical care is the work done over the past few years in the UW Medicine spine program – Sports, Spine & Orthopaedic Health. This program has integrated activities related to diagnoses and care of patients with back pain. Health professionals from multiple specialties – rehabilitation medicine, orthopedics, neurology, neurosurgery and radiology – have examined best practices in the literature and reviewed results from our own program to develop clinical pathways that are more standardized and cost-effective approaches to managing the very large number of patients with back pain.As a result of this research and the resulting changes to our care approaches – as well as the outstanding service offered to patients – patients are very satisfied with our spine program. We know this because we ask patients to self-assess their recovery. By continuously using metrics and measurements to document and monitor program results, UW Medicine can apply for funding that furthers the system’s ability to improve patient care.Q: In your opinion, are there any challenges UW Medicine faces in achieving its goals?PR: There are major challenges in 2012. Our largest challenges, however, are common to all academic health systems around the United States. The foremost challenge is the economy.The economy is adversely affecting support for medical education, clinical care and research. The negative impact on research comes at a time when research has done so much and could do so much more. It is frustrating to see medical research support decline when the outcomes are so exciting and are directly leading to improved health. In 2012, we have the potential to cure and prevent diseases in many areas that could not be addressed in the past. Just this past year, one of our researchers – Suzanne Craft – tested a nasal insulin spray as a treatment for memory loss and dementia. In a randomized controlled trial, she found significant improvement in patients who used the spray. Without adequate research funding, this very promising discovery will not be translated rapidly into new, cost-effective approaches for treatment. Funding support from the National Institutes of Health is extraordinarily important.Another challenge common to all systems, including UW Medicine, is the fact that we must control healthcare costs and in some areas reduce costs rather dramatically while also improving quality, safety and access for patients. A business model of “we must do better” comes at the same time that we must control and reduce healthcare costs.Fortunately, UW Medicine has a large number of hard-working, dedicated and outstanding people, who are working to improve quality, safety, service and access in all of our clinical settings.Q: What do you believe has helped UW Medicine thrive despite hard economic times and downward pressure on the healthcare sector?PR: We are financially stable across our very large health system, and I attribute our fiscal stability to hard work by hundreds of leaders across our system. We are fortunate to have a large number of individuals who are doing their jobs very well. We have also made substantial investments in our financial systems over the last five years, and these investments have resulted in accurate and timely financial information to enable us to make good decisions. UW Medicine has been historically conservative in developing business plans and that approach has served us well in a time of economic turmoil. In short, UW Medicine has thrived because of the outstanding, dedicated individuals who work here.Q: What could other health systems learn from UW Medicine in terms of addressing current healthcare challenges?PR: Since we are one of the largest and best health systems in the world, we have a special responsibility to develop solutions that other systems can emulate. We need to be a model for developing and implementing new approaches to treat and prevent diseases. Our leaders, faculty and staff are working to design new approaches to address clinical care – improvements for specific conditions, the best methods to implement known standards of care, and ways to increase the effectiveness of healthcare teams. We are also developing new approaches to using information technology that facilitate the work of our healthcare professionals and that help patients interact with their healthcare providers.Q: What do you enjoy most about being CEO at UW Medicine?PR: I enjoy all aspects of my position, but if you are asking me to identify one special area, I would say that it is the opportunity to shape the future of healthcare – to focus on how UW Medicine can advance its mission of improving health for all people. I enjoy leading, planning and developing new programs. I enjoy working with people and I am very fortunate to have a large number of outstanding administrative and academic leaders working with me. UW Medicine has more than 21,000 employees and we have culture of collaboration and teamwork. It is a great pleasure to follow all of the programs that are delivering excellence in patient care programs, creating new knowledge on a daily basis and preparing the next generation of healthcare professionals and scientists.Q: What is your leadership philosophy?PR: Lead by example. Lead by serving others. Lead by being an effective communicator. I try to support the individuals who are doing great work by working hard as well.Q: What has been your proudest accomplishment as CEO?PR: Despite the economic turmoil, UW Medicine has remained focused on improving health for all people, putting patients’ interests first and creating active learning for students and trainees. Despite the economy, UW Medicine has continued to achieve excellence in all of our activities.Q: Do you have any personal goals for leading UW Medicine this year?PR: My personal goals and aspirations align with UW Medicine’s goals. I receive great satisfaction from those goals because I value and enjoy UW’s overall mission of seeking to improve health for the overall population. I set my own professional goals in relationship to how I spend my time working with faculty, staff and students to achieve the overall goals for UW Medicine.