Blood shortages weren't uncommon before the pandemic, but COVID-19 stalled blood donations and escalated the situation into a crisis. Blood shortages can have profound effects on patient care, operations and profitability. The good news is that leading US blood centers are adopting innovative management practices and community-driven solutions to help hospitals deliver better patient care and realize better performance.
Becker's Hospital Review recently spoke with two experts on blood supply issues about new and improved ways to manage hospital blood supplies through collaborative and creative actions:
- Chris Miskel President and CEO, Versiti
- Harpreet Sandhu CEO, Stanford Blood Center (Palo Alto, Calif.) and Chairperson of Blood Centers of America
To address blood shortages, community partnerships and hospital relationships are crucial
Due to shifting supply and demand dynamics, blood shortages in the United States have been an ongoing issue. Even prior to COVID-19, blood utilization was growing due in part to the aging population. Another contributor has been earlier diagnosis of cancer patients. Some chemotherapy treatments require platelets and red blood cells.
On the supply side, the demographics of blood donors has shifted over the past decade. "For the past 10 years, the population of donors between 16 and 59 has declined year over year approximately 37 percent," Ms. Sandhu said. "On the flip side, the number of donors aged 60 and older has increased by about 41 percent over the same time period."
Decreases in blood donations have also been attributed to the pandemic. Some individuals have been reluctant to visit blood centers due to social distancing concerns. In addition, the shift to remote school and work has had a significant impact on donations. "Schools represent approximately 20 to 25 percent of all blood donations nationwide," Ms. Sandhu said. "With remote learning, schools haven't been accessible to us. In our area, tech companies are also big sponsors of blood donation events. Employees at many of those organizations continue to work remotely or hybrid, so we can't go onsite for mobile collection programs."
In response, organizations like Stanford Blood Center and Versiti are seeking innovative ways to engage donors by building on relationships with community leaders, healthcare partners and hospitals. One approach is to shift donors from mobile units to donor centers where it is possible to control social distancing and provide top-notch service.
As Mr. Miskel explained, "The pandemic provided us with an opportunity to lean in and strengthen our connections with hospitals. If you take 2019 as a baseline in terms of what we collected with hospitals and compare it to 2020 and 2021, we grew our hospital blood collections by 45 percent." Versiti has found that hospital partnerships work well when there is C-suite sponsorship, a shared mission and space in the hospital facility that is simple and convenient for donors to visit. "When we have a system-level champion, everything really works," he said. "That's where we've driven significant growth in hospital collections."
Innovative practices can take blood supply management to the next level
When it comes to blood supply management, many leading organizations no longer view blood as a commodity and are instead shifting to a more strategic approach. Versiti's partnership with The Ohio State University Wexner Medical Center in Columbus illustrates this shift well.
During the summer of 2019, Versiti became Ohio State's primary blood provider. "Ohio State is keenly aware of being a good steward of the blood supply, particularly during challenging times," Mr. Miskel said. "They manage their inventory very closely and they have very low percentages of waste."
Ohio State studied its ordering patterns and 85 percent of its blood supply now comes in on standing orders. This means employees don't have to spend valuable time ordering and reordering blood.
One reason the Wexner Medical Center partnered with Versiti was the organization's reputation for quality and excellent customer service. Ohio State appreciated Versiti's capabilities like low titer Type O+ fresh whole blood to be used for massive transfusion primarily in trauma cases, antigen-negative units, a reference lab and 24/7 medical coverage. According to Mr. Miskel. "Our reference lab has proven to be invaluable in terms of genotyping patients whose treatment requires blood matched to a molecular level." Going further, Miskel shares, Versiti also provides a unique blood unit antigen query service, which leverages our highly genotyped donor base - the most extensive in the country. Ohio State loves the difference that they've seen over the last couple of years in being able to rapidly scan and locate units in their inventory via antigen query to meet
In addition to its technical capabilities, Versiti has found that communication is essential for effective blood supply management. Its physicians are always available to partners like Ohio State. Versiti holds weekly calls with hospitals to ensure that inventories are managed well. "It sounds easy, but if you don't put people behind it and prioritize it, it doesn't always happen," Mr. Miskel said.
Versiti has also increased its focus on diverse donors. In the last year or two, the organization has educated communities of color about blood donation. This has resulted in material increases in the number of diverse units collected.
"Diverse blood matters," Mr. Miskel said. "Beyond ABO matching, more sophisticated matching is often needed for patients that may reject certain types of blood. Blood with an Ro subtype is very valuable because it is a match for treating patients with special needs like sickle cell disease. We have found that 44 percent of our African American donors have this Ro subtype (around a tenfold higher frequency than Caucasians). When that blood is identified and goes into the inventory, it's more likely to match with a patient with a very special need. Our hospital partners place high value on our ability to rapidly identify and provide these critical and highly-specialized blood products."
During the pandemic, hospitals in Columbus met multiple times per week. It rapidly became clear that Ohio State's blood supply inventory levels were in a better position than those of the other hospitals. "Since we took on Ohio State as a partner, they've grown rapidly in terms of the breadth and depth of their services," Mr. Miskel said. "They've added ambulatory centers and other programs that have grown significantly. The blood provision they need now is very different than it was three years ago. They've been amazed that we have kept up with that demand, but we can do it because we are connected and feel like a real partner."
This type of strategic partnerships exemplifies how innovative blood supply management practices increase patient satisfaction and contribute to efficient care.
Understanding the local community is the key to increased donor recruitment
The health of any local community starts with the health of the independent community blood centers. This means blood centers must understand both current donors and the potential donor community. "We need to learn what types of engagements will inspire the younger generations," Ms. Sandhu said. "We continue to think about technological advancements that will provide a greater sense of connection while respecting the privacy requirements of donors and patients."
The health of any local community starts with the health of the independent community blood centers. This means blood centers must understand both current donors and the potential donor community. "We need to learn what types of engagements will inspire the younger generations," Ms. Sandhu said. "We continue to think about technological advancements that will provide a greater sense of connection while respecting the privacy requirements of donors and patients."
Engagement with donors also requires a macro approach. National partnerships through Blood Centers of America (BCA), organizations like Abbott and other industry players has enabled Stanford Blood Center to collaborate and think innovatively about new opportunities. "We are exploring how to use virtual reality, for example, to engage with younger donors and provide them with a meaningful experience," Ms. Sandhu said. "We must identify what our local communities are responding to and then leverage national partnerships to think outside the box and execute on those ideas."
National networks help independent community blood centers strengthen capabilities
When community blood centers face gaps or shortages, they can turn to national organizations like Blood Centers of America for help. As Ms. Sandhu observed, "We are able to learn about best practices and lean on each other for specialty services. For example, both Versiti and Stanford Blood Center have specialty laboratories, so we support other blood center partners, local and regional hospitals, and other community partners that need very specific or sophisticated testing. Our collective work impacts not only transfusions, but other areas as well. As an example, specialty laboratories support transplant programs."
Resource sharing is a big component of BCA's mission. Multiple BCA members recently created a coalition called the Blood Emergency Readiness Corps. Participants have committed to collecting and providing blood in the event of a disaster anywhere in the United States. "Through BCA, we can go beyond our local footprints and provide support wherever it may be needed," Ms. Sandhu said.
National partnerships also help independent community blood centers deal with issues like the talent shortage in healthcare. For example, Stanford Blood Center is leveraging its partnership with BCA to evaluate programs for team members like national childcare discounts.
Conclusion
Effective approaches to blood supply management are complex. Successful organizations have blended learnings from national partnerships with an in-depth knowledge of local needs. "Blood collection is extremely local," Mr. Miskel said. "Community-based centers sense the heartbeat of their neighborhoods. They can connect with their communities and deliver from a service perspective."
Community blood centers can't be successful in isolation, however. "National and local partnerships are very important," Ms. Sandhu said. "At the end of the day, partnerships between hospital CEOs, administrative and clinical leaders and blood centers in our local communities are what drive value to the patient."