Stanford Blood Center Gilroy, California, United States
Background/Case Studies: Increased hospital demand for platelets (PLTs) created a need for more efficient PLT collection. Review of the PLT donor base revealed that many donors who donated single only PLTs were qualified to donate higher yield products. To maximize efficiency, we decided to remove the single only PLT option from routine PLT collections. Here we report our experience with implementing this change.
Study
Design/Methods: On 9/1/22, the single only PLT option was hidden on all apheresis machines, readjusting the priority list so this option was no longer easily found. In the months prior, multiple communications were sent to PLT donors and the team about the change. In addition, one on one conversations were performed as needed to explain the change and options for donors. To assess impact, a retrospective analysis was conducted for 6-month periods pre and post implementation (Pre - 3/1/22–8/31/22; Post – 9/1/22–2/28/23). Donor and product related factors were compared for total PLT, PLT only, and PLT/plasma (PLS) procedures (proc.). Statistical significance was measured at p < 0.05 using chi square, independent sample t-test and two-proportion z-test as appropriate.
Results/Findings: There was a slight increase in total donors from Pre (1235) to Post (1316), but there was no difference in gender (p = 0.65) or age (p = 0.2). For daily average values, see TABLE 1. There were no statistically significant differences in total proportions of deferrals or failures for total PLT, PLT only, or PLT/PLS proc. (p > 0.10 in all areas). There was a significant decrease in single product collection rate over all (Pre – 26.4%, Post – 14.6%, p < 0.001). The decrease was more pronounced for PLT only proc. (Pre – 23.1%, Post – 1.2%, p < 0.001). However, there was a significant increase in single PLT/PLS proc. (Pre – 35.0%, Post – 66.2%, p < 0.001). Conclusions: The desire to decrease single PLT proc. is not a new concept. However, logistical issues and accommodating donor preferences can hinder implementation. Our success with this strategy was directly related to consistent and clear communication to all staff and donors, along with collaboration and support from leadership. The results show the strategy led to improved split rates, reduced single component rates, and increased PLT products. We saw an increase in single PLT/PLS proc. partly because donors ineligible for a double/triple are only given this option. One lesson learned was how many donors came in around the 9/1/22 deadline, to donate “one last single”. However, donors and staff can be guided and are open to change with the right communication and reinforcement. When the time is invested in discussion and education donors are reminded of why they are donating and fixate less on what they are donating.
Importance of research: To increase platelet collections and improve efficiency, we implemented a strategy to eliminate the collection of single only platelet donations. Moving towards this strategy was a significant culture change for both our team and donors, but with effective communication, education, transparency, and partnership, the implementation was successful with an increase in collections and efficiency. We think it is important to share our experience so others may also consider this change in practice.
