Blood product wastage reduction by utilising low-cost, low-impact multimodal physician-to-physician communication initiatives

Blood usage and wastage at an academic teaching hospital before the initial wave of COVID-19 and during and after its quarantine periods

BACKGROUND

Transfusion services aim to maintain sufficient blood inventory to support patients, even with challenges introduced by COVID-19.

OBJECTIVES

To review blood usage and wastage before, during, and after COVID-19 surges, and to evaluate effects on inventory.

METHODS

In a retrospective review, we evaluated the association between time periods corresponding to the initial wave of COVID-19 (pre-COVID-19, quarantine, and postquarantine) and blood usage/wastage. Data were stratified by period, and χ2 testing was used to examine the association between these time periods and blood usage/wastage.

RESULTS

In the period before COVID-19, the transfusion service used more units, and in the period after quarantine, more units went to waste. Across all time periods, the most-used product was RBCs, and the most wasted product was plasma. A statistically significant association existed between usage (χ2 [6/3209 (0.2%)]) = 24.534; P ≤.001; Cramer V = 0.62), wastage (χ2 [6/775 (0.8%)]) = 21.673; P = .001; Cramer V = 0.118), and time period. The postquarantine period displayed the highest wastage costs ($51,032.35), compared with the pre-COVID-19 period ($29,734.45).

CONCLUSION

Changes in blood inventory use and waste are significantly associated with the onset and continuation of COVID-19.

Patient Blood Management and Its Role in Supporting Blood Supply

Blood donors and voluntary blood donations are essential for ensuring the blood supply that can be maintained by good patient blood management (PBM) practices. This review article explores the role of blood donation in PBM and highlights the importance of donor screening and selection processes in different regions worldwide. The donor health questionnaires and the focused physical examination guidelines have changed in the last decade to increase donor and recipient safety. This article also discusses the status of transfusion practices, including the challenges of ensuring a safe blood supply. Significant among these are the effects of the COVID-19 pandemic on the blood supply chain and the impact of an aging donor population, especially. Promoting autologous donations and other blood conservation strategies are suggested to mitigate these issues. The role of replacement donors and the upper age limit for voluntary blood donation may be decided based on the demography and donor pool. The involvement of C-suite executives is also critical in implementing and running a successful PBM program. The review highlights how these different aspects of blood donation are integral to a successful PBM program and the safety of patients who receive blood transfusions.

Project S.T.O.P (Stop the Over-ordering of Platelets): An initiative to reduce platelet wastages for pediatric open-heart surgeries

INTRODUCTION

Due to a national policy change in the management of unused platelet units from September 2018, there was a drastic increase in the number of platelet units wasted in our institution.

METHODS

Using Quality Improvement (QI) tools, platelet wastages from pediatric heart surgeries was identified as a priority area to work on. An intervention based on the creation of 'Order Sets' for pediatric open-heart surgeries was implemented, standardizing standby platelet orders based on type of surgery and patient weight.

RESULTS

This intervention led to a dramatic improvement in the number of platelets ordered on standby, and consequently a decrease in platelet wastage from 47.6% to 16.9% for pediatric open-heart surgeries, without any reported adverse events.

CONCLUSION

With the creation of Order Sets and continuous education, it was possible to eradicate the practice of requesting unnecessary standby platelets for surgeries. This is an effective patient blood management (PBM) strategy resulting in a significant decrease in platelet wastage rate and substantial cost savings.

Demography and blood donation trends in Saudi Arabia: A nationwide retrospective, cross-sectional study

Background

Blood product supply and utilization are understudied in Saudi Arabia. This study evaluates the trends in Saudi blood banks readiness, donors’ demography, and blood product utilization and wastage.

Study design and methods

A retrospective, cross-sectional study of records obtained from the Ministry of Health (MOH) was initiated to report trends and statistics on annual whole blood donors and blood product utility from 2010 to 2020. Data collected in 2020 was further characterized for donors’ demographics, laboratory readiness, and staffing.

Results

The average number of annual blood donors over the last decade (2010–2020) was 325,847.3 ± 43,160. The forecasted blood donation and dispatch trends suggest a significant increase in blood demand (R² = 0.7582) over annual donation rates (R² = 0.2356). In 2020, 342,460 nationwide blood donations were registered in governmental donation centers and females constituted a mere 2.5 %. Approximately 60 % of whole blood donation was voluntary, 36% was compensatory, and 4% was part of driving license renewal. The highest blood donation rate per 1,000 inhabitants was observed in Taif (69.8) and Alqonfoda (45.0). Eastern directory and Madinah had the most successful donation campaigns attracting 53% and 50% of total annual donations, respectively. Notably, Tabouk, Hai’l, and Albaha had the highest blood product wastage medians.

Conclusion

Blood donation rates and impetus, staffing ratios, and laboratory readiness and wastage varied among the various directories. Laboratory managers and medical directors need to increase efforts to refine current guidelines in order to comply with the transformation plan of the health sector.

Transfusion Medicine Informatics: A Review of Current Practice and a Glimpse into the Future

Clinical informatics has been described as the "relentless pursuit of assisting people" by using data and information technology to improve health care. A core principle is that a person supported by information technology is superior to either a person or machine alone. Striving toward this harmonization, the transfusion medicine field has had a significant number of accomplishments. Clinical informatics interventions have helped achieve better quality, efficiency, and safety in nearly all aspects of transfusion medicine. This review summarizes these accomplishments and provides a preview of novel ideas that could transform transfusion medicine into a proactive, data-driven, and patient-centered discipline.