Bloodless surgery: Establishment of a program for the special medical needs of the Jehovah's Witness community - The gynecologic surgery experience at a community hospital

OBJECTIVE: My purpose was to describe the rationale behind the establishmen t of a hospital-based program instituted to enhance the health of the Jehov ah's Witness community and to evaluate patient profiles and outcomes of gyn ecologic patients treated surgically at our institution, during the past 5 years, whose intake was through the Bloodless Surgery Program and who were not accepting of blood or most blood products. I further describe how a coo rdinated program dedicated to serving this particular population might impr ove outcomes and patient satisfaction. STUDY DESIGN: A retrospective review of the charts of 89 patients, all Jeho vah's Witnesses, who were enrolled through the Bloodless Surgery Program an d underwent gynecologic surgery involving at least 1 eight's hospitalizatio n at our institution between January 1, 1993, and December 31, 1997, was pe rformed. A comparison of patient length of stay, hospital charges, and surg ical blood loss, in a subset of 41 patients who underwent abdominal hystere ctomy, with a cohort of patients not affiliated with the Jehovah's Witnesse s or the Bloodless Surgery Program was performed. Data regarding patient sa tisfaction were obtained through surveys and are presented. RESULTS: Patients enrolled through the Bloodless Surgery Program and underg oing abdominal hysterectomy were significantly younger (average age 43.4 vs 47.7 years) and incurred significantly lower hospital charges (average cos t $8754 vs $9539). No significant difference between the group studied and the control group could be found in average length of stay or the average c hange between preoperative and postoperative hemoglobin levels. Data from p atient satisfaction surveys suggest a high level of satisfaction with the B loodless Surgery Program. CONCLUSION: A program dedicated to the special needs of the Jehovah's Witne ss community can be instituted in a community-based hospital with no eviden ce of increased morbidity, as evidenced by length of stay, hospital charges , and surgical blood loss, in a gynecologic patient population. Development of such programs is associated with a high level of patient satisfaction a nd the potential for improved patient care.