Reducing avoidable blood transfusions in patients admitted to critical care and high-risk surgical units in Alberta and reducing blood volume loss through implementation of small-volume tubes in patients admitted to critical care and high-risk surgical units in Alberta

Led by Dr. Daniel Niven and funded by an Alberta Innovates PRIHS grant, the Don’t Misuse My Blood (DMMB) initiative aims to:

• Reduce potentially low-value transfusions of red blood cells, platelets, fibrinogen, plasma, and prothrombin complex concentrates across 39 adult and pediatric critical care and high-risk surgical units in Alberta.

• Minimize avoidable blood loss by transitioning 17 hospitals to small-volume blood collection tubes, reducing iatrogenic blood loss and associated healthcare costs.

*Please note: The original project title references “blood tests,” but Phase 2 has since shifted to focus on reducing blood volume loss through small-volume tube implementation.

The transition to small-volume blood collection tubes was completed in February 2026, following full implementation of the transfusion reduction strategy across all 39 sites in June 2024.This project was supported by PLP Calgary’s expertise in data analysis and reporting, including the development of a custom-built data pipeline that enabled timely, site-specific A&F. Quarterly A&F reports were distributed to clinical teams, providing actionable insights that supported behavior change and clinician engagement.

An interactive dashboard with key project metrics has been completed and launched provincially. This system allows local sites and individual physicians to receive continuous feedback on their performance and allows for monitoring to ensure improvements are sustained. PLP has worked with ACA to develop strategies to provide additional support for sites and individual physicians if the use of unnecessary blood products increases.

Phase 3, expanding the implementation of small-volume blood collection tubes throughout participating hospitals was completed in February 2026.

Cumulative project impact (June 2023 to March 2026):

• 39% reduction in potentially unnecessary blood product transfusions

• 1,357 patients avoided unnecessary blood product exposure

• $1,716,190 in costs savings realized

• 2,884 transfusions avoided

• 21,802 kgs of CO₂ equivalent saved

Coordinated, evidence‑informed blood utilization practices are reducing low‑value transfusions and avoidable blood loss, strengthening physician decision‑making and delivering sustained clinical, financial, and environmental benefits across Alberta’s critical care and high‑risk surgical settings.