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Five Points of Interest from International Consensus Conference

I recently attended the International Consensus Conference for Patient Blood Management in Frankfurt, Germany. And here are five points worth pondering:

1. Many patient-care episodes are multifaceted and depend upon coordination with professionals outside the laboratory. We need to be better about discussing our efforts. Complex issues are virtually never black and white, so by providing the pertinent details, others are able to answer the question, "What should this look like for a particular context?" Because many articles are published with incomplete information, interventions can only be talked about in the most general of terms.

2. Several research articles had to be excluded from consideration, when making recommendations, because of inappropriate design. We need to be more deliberate about interacting with the medical literature and how we disseminate new knowledge. As a consumer of new knowledge, I want there to be an enlightening conversation via letters to the editor. As a generator of new knowledge, I want my work to inform the clinical recommendations of my peers. Either way, this was a wake-up call to be more engaged and help each other conduct informative research.

3. Equity becomes a tricky thing when developing international recommendations. Before this meeting, I had tried to attend international meetings for exposure to new and different perspectives for the classic challenges. However, this was the first meeting when I appreciated the challenge of an international consensus recommendation. With several models of health care internationally, how can one recommendation serve all? There always seem to be unintended consequences, which seems to be magnified when on the international stage. I had been ignorant of this challenge before the meeting. How may we become more aware of unintended consequences beforehand? In other words, when implementing something new, what will be your counterbalance measure?

4. We should learn from other professions. When talking about an education initiative, we should pause to consider what the education experts know about the topic. When talking about change management, we should pause to consider what the business literature says are best practices. I will certainly admit that their knowledge may not generalize to our field; however, we should be learning from others more than we currently do.

5. In my experience, successful implementation of new recommendations depends on sustainability. In other words, what is the process? "One and done" implementations are just that . . . done and forgotten! How can we become more iterative with the projects that matter for patient care?

In summary, this was my first international consensus conference, and it made me more aware of several issues important to my medical practice.

What laboratory medicine questions have you been pondering lately? I would appreciate hearing from you—please comment below.

Justin Kreuter

Justin Kreuter

Justin Kreuter, M.D., is a clinical pathologist at Mayo Clinic in Rochester, Minnesota. His practice consists of both general and subspecialty aspects of clinical pathology. At Federal Medical Center-Rochester, Dr. Kreuter runs the general laboratory that supports a local in-patient population and does a large amount of reference work. At Mayo Clinic, Dr. Kreuter's time is split between the transfusion medicine service and transplant laboratory. In addition to clinical activities, his academic interests include several aspects of medical education, including teaching clinical judgment, frameworks for feedback, and reflection in medical practice.