Theme editorial| Volume 18, ISSUE 4, P565-573, December 1997

The transfusion service is an integral and important component of the hospital and should not be outsourced

      This paper is only available as a PDF. To read, Please Download here.


      Hospitals are under increased pressure to decrease operating costs. Hospital-based laboratories, blood banks (transfusion services), increasingly face the potential of being outsourced as hospitals try to survive the current waves of managed care. A number of complicated and unique services are provided by the hospital-based transfusion service and physician. Clinical consultation, complicated immunohematological procedures, apheresis, participation in a complex array of patient-care services, clinical research, ever increasing regulatory issues, and quality assurance activities are only a few of the challenges in today's transfusion medicine environment. This paper will focus on the hospital-based transfusion service, and the transfusion medicine physician, and present arguments as to why this service should remain close to the patient's bedside and not be outsourced.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Transfusion and Apheresis Science
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Maluf NSR
        History of blood transfusion.
        J Hist Med. 1954; 9: 59-107
        • Crile G
        The technique of direct transfusion of blood.
        Ann Surg. 1907; 46: 329-332
        • Fantus B
        The therapy of the Cook County hospital.
        J Am Med Assoc. 1937; 109: 128-131
        • Telischi M
        Evolution of Cook County hospital blood bank.
        Transfusion. 1974; 14: 623-628
        • Klein HG
        Transfusion medicine: the evolution of a new discipline.
        J Am Med Assoc. 1987; 258: 2108-2109
        • Blajchman MA
        Defining transfusion medicine.
        Trans Med Rev. 1990; 4: 169
        • Fuchs VR
        Managed care and merger mania.
        J Am Med Assoc. 1997; 277: 920-921
        • Silver G
        Editorial: the road from managed care.
        Am J Pub Health. 1997; 87: 8-9
        • Clough JD
        Treating populations rather than individuals: the subtle danger of managed care.
        Cleve Clin J Med. 1997; 64: 120-121
        • Triulzi DJ
        • Portman WH
        • Mango PD
        • Lopez-Plaza I
        • Hahn LF
        Centralized transfusion service: a novel approach to the delivery of transfusion services.
        Trans Med Rev. 1995; 9: 123-130
        • Beck ML
        • Tilzer LL
        Red cell compatibility testing: a perspective for the future.
        Trans Med Rev. 1996; 10: 118-130
        • Hoeltge GA
        • Domen RE
        • Rybicki LA
        • Schaffer PA
        Multiple red cell transfusions and alloimmunization: experience with 6996 antibodies detected in a total of 159 262 patients from 1985 to 1993.
        Arch Pathol Lab Med. 1995; 119: 42-45
        • Devine P
        • Goldstein R
        • Linden JV
        • Postoway N
        • Hoffstadter LK
        • Hines DM
        Data on apheresis, blood collection, and transfusion-related activities: statistical analyses of the American Association of Blood Banks institutional membership questionnaires.
        Transfusion. 1996; 36: 375-381
        • Domen RE
        Preoperative autologous blood donations: clinical, economic, and ethical issues.
        Cleve Clin J Med. 1996; 63: 295-300
        • Domen RE
        • Rybicki LA
        • Popovsky MA
        • Milam JD
        Fellowship training programs in blood banking and transfusion medicine: results of a national survey.
        Am J Clin Pathol. 1996; 106: 584-587
        • Mintz PD
        Quality assessment and improvement of transfusion practices.
        Hematol Oncol Clin NA. 1995; 9: 219-232
        • Popovsky MA
        • Moore SB
        • Wick MR
        • Devine P
        • Pineda AA
        • Taswell HF
        A blood bank consultation service: principles and practice.
        Mayo Clin Proc. 1985; 60: 312-314
        • Soumerai SB
        • Salem-Schatz S
        • Avorn J
        • Casteris CS
        • Ross-Degnan D
        • Popovsky MA
        A controlled trial of educational outreach to improve blood transfusion practice.
        J Am Med Assoc. 1993; 270: 961-966
        • Hebert PC
        • Wells G
        • Marshall J
        Canadian critical care trials group transfusion requirements in critical care: a pilot study.
        J Am Med Assoc. 1995; 273: 1439-1444
        • Popovsky MA
        • Triulzi D
        The role of the transfusion medicine consultant.
        Am J Clin Pathol. 1996; 105: 798-801
        • Rosen NR
        • Bates LH
        • Herod G
        Transfusion therapy: improved patient care and resource utilization.
        Transfusion. 1993; 33: 341-347
        • Aubuchon JP
        Blood transfusion options: improving outcomes and reducing costs.
        Arch Pathol Lab Med. 1997; 121: 40-47
        • McCullough J
        The continuing evolution of the nation's blood supply system.
        Am J Clin Pathol. 1996; 105: 689-695
        • Smith RD
        • Benson ES
        • Anderson RE
        • Tholen D
        Some characteristics of the community practice of pathology in the United States.
        Arch Pathol Lab Med. 1989; 113: 1335-1342
        • Domen RE
        Perilous times in pathology education.
        Am J Clin Pathol. 1993; 99: 216
        • Gottfried EL
        • Kamoun M
        • Burke MD
        Laboratory medicine education in United States medical schools.
        Am J Clin Pathol. 1993; 100: 594-598
        • McDonald JM
        • Smith JA
        Value-added laboratory medicine in an era of managed care.
        Clin Chem. 1995; 41: 1256-1262
        • Gilbertson J
        • Mango P
        • McLinden S
        • Becich MJ
        • Triulzi D
        The Pittsburgh reference laboratory alliance: a model for laboratory medicine in the 21st century.
        Am J Clin Pathol. 1997; 107: 387-394
        • Shively JA
        • Grove-Rasmussen M
        • Hummer GJ
        • Kellner A
        • Muirhead EE
        • Perkins HA
        Survey of blood bank physicians and medical directors.
        J Am Med Assoc. 1971; 217: 1085-1087