1. 1

    Do not use peri-operative transfusion for otherwise reversible anaemia prior to elective surgery

  2. 2

    Do not transfuse red blood cells for iron deficiency where there is no haemodynamic instability

  3. 3

    Do not transfuse more units of blood than necessary

  4. 4

    Do not order a group and crossmatch when a group and antibody screen would be appropriate

  5. 5

    Do not transfuse standard doses of fresh frozen plasma to correct a mildly elevated (<1.8) international normalized ratio prior to a procedure


How this list was developed

As part of the Evolve program, the RACP Policy and Advocacy team has worked with the Australian and New Zealand Society of Blood Transfusion (ANZSBT) to develop and finalise this Evolve Top-5 list of low-value care that pertains to the specialty.

Per usual processes, the list of low value practices was first identified by the ANZSBT Council and condensed to the top-5 recommendations, through a membership survey, extensive research and rounds of redrafting under the guidance of the ANZSBT Council. The list was subjected to an extensive review and consultation process that involved RACP-affiliated specialty societies and other key colleges via the Choosing Wisely program. Feedback from the consultation has been integrated into the top-5 recommendations by the ANZSBT and approved by its Council in December 2021.

Version 1 published January 2022.