By Marcia Frellick

Surgery without transfusions saves money, improves patient outcomes, proponents say. So what's holding you back?

Once thought of as a way to treat Jehovah's Witnesses, whose religious beliefs don't allow transfusions, blood management programs are growing in number and scope in U.S. hospitals.

Sherri Ozawa, R.N., clinical director of the Institute for Patient Blood Management at Englewood (N.J.) Hospital and Medical Center, put the current number at about 100, although she adds that without established national criteria on what qualifies as a blood management program, the exact number is hard to pinpoint.

"I'm aware of about 100 active programs and I'm aware of at least a couple hundred more in development," says Ozawa, also a board member for the Society for the Advancement of Blood Management. In 1994, when Englewood's program began, there were fewer than 10 programs, she says.

The programs have evolved from a way to treat a small subset of the population for whom transfusions aren't an option to a way for hospitals to evaluate what they're spending on blood, examine outcomes after transfusions and explore whether some transfusions are unnecessary.