Original article

Blood Transfusion - 3 2021 (May-June)

Maturity Assessment model for Patient Blood Management to assist hospitals in improving patients’ safety and outcomes. The MAPBM project


Key words: Patient Blood Management, patient safety, transfusion, maturity assessment, benchmarking
Publication Date: 2020-09-18


Background - Patient blood management (PBM) is an evidence-based care bundle with proven ability to improve patients’ outcomes by managing and preserving the patient’s own blood. Since 2010, the World Health Organisation has urged member states to implement PBM. However, there has been limited progress in developing PBM programmes in hospitals due to the implicit challenges of implementing them. To address these challenges, we developed a maturity assessment model (MAPBM) to assist healthcare organisations to measure, benchmark, assess in PBM, and communicate the results of their PBM programmes. We describe the MAPBM model, its benchmarking programme, and the feasibility of implementing it nationwide in Spain.
Materials and methods - The MAPBM considers the three dimensions of a transformation effort (structure, process and outcomes) and grades these within a maturity scale matrix. Each dimension includes the various drivers of a PBM programme, and their corresponding measures and key performance indicators. The structure measures are qualitative, and obtained using a survey and structured self-assessment checklist. The key performance indicators for process and outcomes are quantitative, and based on clinical data from the hospitals’ electronic medical records. Key performance indicators for process address major clinical recommendations in each PBM pillar, and are applied to six common procedures characterised by significant blood loss.
Results - In its first 5 years, the MAPBM was deployed in 59 hospitals and used to analyse 181,826 hospital episodes, which proves the feasibility of implementing a sustainable model to measure and compare PBM clinical practice and outcomes across hospitals in Spain.
Conclusion - The MAPBM initiative aims to become a useful tool for healthcare organisations to implement PBM programmes and improve patients’ safety and outcomes.


Elvira Bisbe - Anaesthesia Department, Hospital del Mar Medical Research Institute, IMIM, Barcelona, Spain

Albert Garcia-Casanovas - Perioperative Medicine Research Group, Hospital del Mar Medical Research Institute, IMIM, Barcelona, Spain

Carles Illa - Healthcare, IQVIA Spain, Barcelona, Spain

Jordi Varela - Gesclinvar Consulting S. L. Avances en Gestión Clínica, Barcelona, Spain

Misericordia Basora - Anaesthesia Department, Hospital Clínic de Barcelona, Barcelona, Spain

Marta Barquero - Anaesthesia Department, Hospital Parc Taulí de Sabadell, Sabadell, Spain

Maria J. Colomina - Anaesthesia Department, Hospital Bellvitge, Hospitalet de Llobregat, Barcelona, Spain

Lucia González - Healthcare, IQVIA Spain, Barcelona, Spain

Axel Hofmann - Institute of Anaesthesiology, University Hospital Zurich, Zurich, Switzerland; School of Surgery, University of Western Australia and School of Public Health Research, Perth, Australia

MAPBM Working Group (listed in Appendix 1) - MAPBM Working Group

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