Analyzing the impact of systems-based hematologist in the healthcare system at an academic medical center
Over the next decade, there is a predicted shortage of nonmalignant hematologist to maintain the workforce in the United States. To address this, the American Society of Hematology described the creation of the healthcare systems-based hematologist (SBH). The role of SBH has the potential to provide high-value, cost-conscious care to the healthcare system. In 2011, an Anticoagulation and Bleeding Management Medical Directorship position for a SBH was created at our healthcare system. We described our 6-year experience as SBH at a 750-bed tertiary academic medical center to improve clinical outcomes while reducing costs. Via four different initiatives, we were able to provide high-value, cost-conscious care as SBH by reducing cost of heparin-induced thrombocytopenia management, optimizing blood product utilization using goal-directed algorithms, reducing inappropriate thrombophilia testing and improving inferior vena cava filter retrieval rates. To ensure continuing success as a SBH, business plans need to include education, enforcement, monitoring, feedback, validation of safety and outcomes and a shared vision among leadership.
KeywordsCost savings Healthcare system Quality improvement
All authors participated in the writing of the manuscript, and have seen and approved the submitted version. All authors were involved in the conception and design of the study, and the analysis of the data.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
For this type of study formal consent is not required.
- 2.Pierce W, Mazur J, Greenberg C, Mueller J, Foster J, Lazarchick J (2013) Evaluation of heparin-induced thrombocytopenia (HIT) laboratory testing and the 4Ts scoring system in the intensive care unit. Ann Clin Lab Sci 43:429–435Google Scholar
- 4.Vaughn CD, Mazur J, Foster J, Lazarchick J, Boylan A, Greenberg CS (2014) Implementation of a heparin-induced thrombocytopenia management program reduces the cost of diagnostic testing and pharmacologic treatment in an academic medical center. Blood 124:Abstract 4848Google Scholar
- 6.Greenberg CS, Vaughn C, Boylan A et al (2015) Analyzing the impact of implementing a systems-based hematologist into the healthcare delivery system at an academic medical center. Blood 126:Abstract 4467Google Scholar
- 12.Lim MY, Vaughn C, Shane LT, Greenberg CS (2016) Strategies to improve safety and outcomes utilizing systems-based hematologists in IVC filter placement and management in an Academic Medical Center. Blood 128:Abstract 4739Google Scholar
- 13.Bracewell S, Kuhlman T, Guimaraes MS et al. Quality improvement (QI) project to ensure appropriate follow-up for patients post inferior vena cava filter (IVCF) placement. Abstract E-057. https://www.aur.org/uploadedFiles/Archives/Research Papers.pdf. Accessed 3 Oct 2018