Home Blood Transfusions – a Feasible Trans-sectoral Collaboration

Background & Aim The Danish public healthcare system includes services provided by the hospitals, the general practitioners (GPs) and the municipalities. Initiatives have been made to strengthen communication and collaboration between these sectors leading to improved patient treatment, reduced rate of admissions and shorten length of stay at hospital. The Emergency Department at Viborg Regional Hospital is collaborating with a group of specially trained nurses from Viborg Municipality (Viborg Acute Team, VAT), to perform more advanced treatment for patients after discharge from hospital. In December 2014 this collaboration was expanded to include home blood transfusion. This study was conducted to evaluate the quality of the home blood transfusions. Method The referring GP discussed anaemic patients suitable for home blood transfusion, with the emergency physician on duty. If the patients met the inclusion criteria, VAT was contacted. VAT preformed a pretransfusion visit at the patient’s home, to insure informed consent and a blood sample for compatibility testing. The next day VAT brought the blood from the Immunology Department. Thorough identification was made using scanners. VAT stayed during the transfusion, monitoring the patient’s vital signs. The Immunology and Emergency physicians were available on-call, in case of complications. Results In a one year period 65 home blood transfusions were conducted on 31 patients aged 64-97 years. The patients were mainly diagnosed with chronic anemia and serious co-morbidity, which compromised their ability to come to the hospital. No complications to the procedure emerged and no admissions to hospital followed. Conclusions Home blood transfusion was implemented as a trans-sectoral collaboration between GPs, VAT and the Immunology and Emergency Departments, as an example of providing health care service for old, disabled or seriously ill patients in their home. The communication and the working procedures were comprehensive, but feasible.