(P-PB-13) Managing Hospital Blood Supply During the Blood Shortage Crisis

Background/Case Studies: In January 2022, a national blood shortage was declared by some blood suppliers, the worst in more than a decade. As hospitals' blood needs were not met, blood bank (BB) medical directors had to take action by introducing new strategies and changing current policies in blood product distribution.

Study

Design/Methods: A survey was developed to provide insight into strategies undertaken to face the crisis. The study was IRB waived. The survey was distributed electronically to blood banks across the US. Data were analyzed using quantitative statistics.

Results/Findings: A total of 31 responses from 17 states were analyzed, out of which 80.6% were given by blood bank medical directors. They showed that 90% of the respondents were certified/trained in transfusion medicine, and practiced in a hospital as a part of a health system. Participants were from hospitals with a wide range of annual blood product transfusion volumes (2,000 to 1.2 million transfusions/year). According to the survey, 73.3% reported they have been impacted by the blood shortage crisis. The majority (72.7%) reported a shortage of mainly pRBCs, although other blood products were also affected. Thirty percent reported that they did not have the policy to relay information regarding blood inventory levels prior to the crisis. Among the strategies to optimize the blood inventory when a critical level is reached, respondents would contact other hospitals for help (30.3%), order from secondary suppliers (60.6%), cancel elective surgeries (60.6%), cancel transplantations (9.1%), divert traumas (21.2%), split platelet units (36.4%), or split pRBCs (18.2%). However, during the crisis, only 37.9% canceled elective surgeries, 13.8% diverted traumas, and 10.3% canceled solid-organ and bone marrow transplants. Notably, 58.6% of the respondents did not have to cancel or divert any procedures. BB administration implemented different methods to optimize blood product utilization, like lowering the threshold for pRBCs (55.2%) and platelet transfusion (44.8%), adjusting the number of products in MTP cycles (44.8%), using cell salvage devices (44.8%), reviewing orders and communicating with the ordering physician for possible alternatives (10.5%), and splitting units and/or issuing only one unit at a time (10.5%). To prevent blood shortages in the future respondents would practice sharing blood among hospitals within a health system (64.3%), engage in donor recruitment (46.4%), share blood products among local or regional hospitals (39.3%), and consider hospital-based donor center/blood drives (32.1%).

Conclusions: This blood crisis has significantly impacted blood product distribution potentially compromising patient care. Data from the survey provides insight into strategies that could be useful to mitigate the effects of blood product shortages.

Importance of research: This blood crisis has significantly impacted blood product distribution potentially compromising patient care. Data from the survey provides insight into strategies that could be useful to mitigate the effects of blood product shortages.