Table 1 Summary of the simplified recommendations with level of evidence (LoE) and consensus of recommendation (CoR)

 Key leaders; involvement of stakeholders

C

100

 Collection of PBM-related metrics

C

90

 Education initiatives; standard operating procedures, clinical protocols, visual aids, checklists; algorithms

C

100

 Massive hemorrhage protocols; coagulation and transfusion algorithms

C

100

 Online PBM e-learning course

C

100

 Education at medical schools and hospital level

C

100

 Preoperative screening, diagnosis, and treatment of anemia

B

100

 Intravenous iron if oral iron is not tolerated or if surgery <4–6 weeks

B

100

 Erythropoiesis-stimulating agents if nutritional deficiencies have been ruled out, corrected, or both

B

100

 Elective surgery should be postponed until preoperative anemia has been classified and treated, if possible

C

100

 Avoiding unnecessary laboratory tests, lower frequency of sampling, using the smallest collection tube size

C

100

 Closed in-line flush blood sampling devices for arterial (and central) lines

B

100

 Appropriate cessation strategies for anticoagulation and antiplatelet therapy

C

100

 Intraoperative approaches (meticulous hemostasis, minimally invasive surgery, laparoscopic surgery, diathermy dissection, physicians’ mindfulness regarding limiting blood loss, topical hemostatic agents)

B

100

 Coagulation algorithm (preoperative assessment, ensuring basic conditions for hemostasis, reversal of anticoagulants, point-of-care diagnostics, optimized coagulation management, use of clotting factor concentrates)

B

100

 Tranexamic acid

A

100

 Autologous blood cell recovery (cell salvage)

A

100

 Physician order entry with clinical decision support

B

100

 Patient’s informed consent prior transfusion; hand-written/computer-generated forms with detailed outline of transfusion benefits, risks, and alternatives; information in discharge summary; patient’s own preferences

C

80