Reduce RBC and FFP Waste, Improve ROI
Learn more from this Blood Transport and Storage Initiative that resulted in significant ROI
I recently read an article in the journal Transfusion1 in reference to reducing red blood cell (RBC) and plasma (FFP) waste. The study showed significant reduction in RBC and FFP waste by using a new blood transport and storage system, and a significant return on their investment in the new system (estimated savings of $9000/month for their institution).
While the article doesn’t speak to temperature indicators, it does seem to validate that there is a trend toward cooler storage in the OR being considered “intraoperative storage,” which is significant.
For those of us sensitive to blood waste (and associated costs) due to time-temperature issues, this study has a wealth of valuable information and powerful messages: The article cites a national waste rate for hospital-issued blood products ranging from 0% to 6%, and a common reason for blood waste being inadequate intraoperative storage.2
- The article describes how most of their blood waste was from either temperature or time (away from the blood bank) excursions, and that 70% of those losses came from blood product issued to the OR in coolers.
- In the second paragraph they state that “AABB standards require red blood cell and plasma units to be maintained at a temperature of 1-10°C during transport and 1-6°C during intraoperative storage."
- They go on to state (under Materials and Methods) that “holding product in the OR represents a storage condition"… and “the storage (1-6°C), not the more lenient transport (1-10°C) temperature range needed to be maintained.”
Their previous procedure was to issue blood products to the OR in off-the-shelf commercial coolers that were validated to hold product at 1-10°C for 8 hours. They changed to a new, more expensive cooler that incorporated specialty phase change material that is validated to hold 1-6°C for 18 hours. As a result of the new system and strategy, they have improved their “storage” compliance to 1-6°C and reduced waste from 1.20% to 0.06%, which they calculate to save the $9,000 per MONTH.
The result of this study suggests that incorporating a new, longer duration blood shipping and storage container has allowed the OR to store blood for up to 18 hours at 1-6°C while meeting AABB’s more strict guidelines and has produced significant cost savings and notable return on investment
It would be interesting to see the savings if they incorporated a Safe-T-Vue 6 indicator in this study.
REFERENCES:
1. Brown MJ, Button LM, Badjie KS, Guyer JM, Dhanaroker SR, Brach EJ, Johnson PM, Stubbs JR. Implementation of an intraoperative blood transport and storage initiative and its effect on reducing red blood cell and plasma waste, Transfusion 2014;54: 710-07.
2. Heltimiller ES, Hill RB, Marshall CE, Parsons FJ, Berkow LC, Barrasso CA, Zink EK, Ness PM. Blood wastage reduction using Lean Sigma methodology. Transufions 2010;50: 1887-96.