Background/Case Studies: In 2021, a tertiary Canadian cardiovascular hospital transfusing nearly 1500 apheresis/buffy-coat platelet units/year reached out to its blood centre to help with its local inventory management following a platelet shortage for a patient undergoing a cardiovascular surgery. The provincial blood centre is located 2 km from the facility and offers two daily routine deliveries. Urgent deliveries are available on an “as needed” basis and are filled with the oldest platelet units available (7-day shelf life) in comparison to routine orders. The hospital policy was to keep a minimum of 6 platelet units and an urgent order was placed automatically to replace units sent to the ward. Consequently, urgent orders were received daily at the blood centre which put strain on the resources dedicated to emergency deliveries. Following analysis of the hospital’s platelet utilization and ordering practice, a pilot project was proposed where a minimum target inventory of 12 units (weekdays) and 10 units (weekends) would be the new standard. The primary aim of this study was to assess the benefits of a new inventory management system.
Study
Design/Methods: In this retrospective cross-sectional study, rates of platelet deliveries were compared between pre (February to November 2021) and post (February to November 2022) pilot program implementation. Hospital Data was extracted from e-Traceline and blood centre data from e-Progesa. Pre and post implantation platelet delivery rates were compared using z-test for two proportions at an alpha level of 0.05.
Results/Findings: A total of 1355 platelet units (mean of 2.53 [SD = 1.01] per delivery) were delivered in the pre-period compared to 1542 units (mean of 4.63 [SD = 1.70] per delivery, p < 0.00001) in the post-period. Despite an increase in distribution between the two periods, a 40% decrease in the absolute number of deliveries was observed (535 pre vs 333 post). There was a significant reduction in the urgent request rate (92% pre vs 49% post, p < 0.00001) leading to an improved remaining shelf life of 2 to 4 days (63% pre vs 82% post, p < 0 .00001). The platelet wastage rate did not increase (5.6% pre vs 7% post, p = 0.13104). Conclusions: This collaborative pilot project was beneficial to both stakeholders. There was better utilization of emergency delivery services. The increased number of platelet units in inventory led to decreased wait times for urgent requests and also reduced stress for the medical laboratory technologists. Finally, having a greater proportion of fresher platelet units minimized the impact on platelet wastage. Future similar initiatives are planned to further optimize provincial platelet inventory management.
Importance of research: This study highlights how hospitals and blood suppliers, who bring together their expertise and share data (distribution, transfusion), could streamline platelet inventory management. With fewer resources in hospital labs, we illustrated the impact of collaborative work to resolve challenges such as low platelet inventory on site and high rate of urgent deliveries. Blood suppliers have the ability to assist hospitals with data analysis to help determine their optimal local inventory level.
