{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T00:38:50Z","timestamp":1792715930832,"version":"4.5.0"},"reference-count":40,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T00:00:00Z","timestamp":1792627200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T00:00:00Z","timestamp":1792627200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000061","name":"Fogarty International Center","doi-asserted-by":"publisher","award":["1D43TW010345"],"award-info":[{"award-number":["1D43TW010345"]}],"id":[{"id":"10.13039\/100000061","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vox Sanguinis"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Objectives<\/jats:title>\n                    <jats:p>South African hospitals face a high anaemia burden, variable access to patient blood management (PBM) modalities and uneven adoption of evidence\u2010informed transfusion practice. Pragmatic, context\u2010appropriate tools are needed to standardise practice and support implementation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>\n                      We conducted semi\u2010structured interviews with PBM champions (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200916, across six provinces in South Africa) to generate candidate toolkit items, then validated these via a three\u2010round e\u2010Delphi with a panel of 11 subject experts. Items were rated on a 3\u2010point Likert scale (1\u2009=\u2009Essential; 2\u2009=\u2009Useful; 3\u2009=\u2009Unnecessary). Consensus was defined as \u226580% of the panel selecting the same option. Stability was defined as \u226420% (two or fewer) panellists who changed their response by Round 3.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Round 1 included 793 statements; consensus was reached on 49.1% of items. Round 2 presented 400 non\u2010consensus statements remaining after Round 1, and an additional set reached consensus, raising the cumulative total to 72.5%. Round 3 included 214 statements; by the end of Round 3, cumulative consensus was 88.1%. A further 10.8% of items met the predefined stability criterion without reaching consensus. Only eight items were unresolved.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This mixed\u2010methods process yielded a context\u2010aware PBM toolkit framework for South Africa. It prioritises pre\u2010operative anaemia optimisation, restrictive transfusion practice, standardised peri\u2010operative haemorrhage protocols, fit\u2010for\u2010purpose education and practical monitoring and accountability tools with clear ownership.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/vox.70391","type":"journal-article","created":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T23:55:15Z","timestamp":1792713315000},"source":"Crossref","is-referenced-by-count":0,"title":["A content\u2010validated framework for a patient blood management toolkit for South Africa: A mixed\u2010methods\n                    <scp>e<\/scp>\n                    \u2010Delphi study"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3056-0482","authenticated-orcid":false,"given":"Vanitha","family":"Rambiritch","sequence":"first","affiliation":[{"name":"Medical Division South African National Blood Service  Johannesburg South\u00a0Africa"},{"name":"School of Clinical Medicine University of the Free State  Bloemfontein South\u00a0Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4657-7318","authenticated-orcid":false,"given":"Estelle R.","family":"Verburgh","sequence":"additional","affiliation":[{"name":"Division of Clinical Haematology, Department of Medicine University of Cape Town  Cape Town South\u00a0Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2885-3342","authenticated-orcid":false,"given":"Vernon J.","family":"Louw","sequence":"additional","affiliation":[{"name":"Division of Clinical Haematology, Department of Medicine University of Cape Town  Cape Town South\u00a0Africa"},{"name":"Division of Clinical Haematology, Department of Medicine Stellenbosch University  Cape Town South\u00a0Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,22]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"crossref","DOI":"10.1186\/s13741-017-0061-8","article-title":"\u201cSimplified international recommendations for the implementation of patient blood management\u201d (SIR4PBM)","volume":"6","author":"Meybohm P","year":"2017","journal-title":"Perioper Med"},{"key":"e_1_2_9_3_1","doi-asserted-by":"crossref","first-page":"476","DOI":"10.1213\/ANE.0000000000005873","article-title":"A global definition of patient blood management","volume":"135","author":"Shander A","year":"2022","journal-title":"Anesth Analg"},{"key":"e_1_2_9_4_1","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1111\/voxs.12433","article-title":"Implementing a patient blood management programme in Brazil: challenges and implications for developing countries","volume":"14","author":"Benites BD","year":"2019","journal-title":"ISBT Sci Ser"},{"key":"e_1_2_9_5_1","doi-asserted-by":"crossref","first-page":"1347","DOI":"10.1111\/trf.14006","article-title":"Improved outcomes and reduced costs associated with a health\u2010system\u2010wide patient blood management program: a retrospective observational study in four major adult tertiary\u2010care hospitals","volume":"57","author":"Leahy MF","year":"2017","journal-title":"Transfusion"},{"key":"e_1_2_9_6_1","doi-asserted-by":"crossref","first-page":"2807","DOI":"10.1111\/trf.13260","article-title":"Implementation of a patient blood management monitoring and feedback program significantly reduces transfusions and costs","volume":"55","author":"Mehra T","year":"2015","journal-title":"Transfusion"},{"key":"e_1_2_9_7_1","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1016\/j.tmrv.2016.05.012","article-title":"Patient blood management bundles to facilitate implementation","volume":"31","author":"Meybohm P","year":"2017","journal-title":"Transfus Med Rev"},{"key":"e_1_2_9_8_1","doi-asserted-by":"crossref","first-page":"983","DOI":"10.1001\/jama.2019.0554","article-title":"Patient blood management: recommendations from the 2018 Frankfurt consensus conference","volume":"321","author":"Mueller MM","year":"2019","journal-title":"JAMA"},{"key":"e_1_2_9_9_1","unstructured":"WHO.Guidance on implementing patient blood management to improve global blood health status; 2025. 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