Anesthesiology. 118(6):1286-1297, June 2013.
The recommended maximum surgical blood order schedule (MSBOS) for common surgical procedures that was published over 30 yr ago may be obsolete because many new procedures have been introduced while others have been improved upon. Data on 53,526 surgical patients having 1,632 types of surgical procedures were acquired from an anesthesia information management system (AIMS). The type and crossmatch–to–transfusion ratios of all surgical services except cardiac and vascular/transplant greatly exceeded the proposed optimal ratio of 2. An updated, institution-specific MSBOS for each surgical specialty was created from a novel blood order algorithm and the AIMS data. Implementing the algorithm and an institution-specific MSBOS could improve operating room efficiency, enhance patient safety, and reduce costs.