Even simple, inexpensive changes can have a big impact on solving challenging problems. A great example is the University of Florida (UF) College of Medicine successful initiative that dramatically reduced blood product waste and saved the hospital nearly $20,000 in five months, just by replacing text-heavy instruction labels for blood transport coolers with intuitive, icon-based labels.
A multidisciplinary committee comprising blood bank staff, anesthesiology staff and operating room managers determined that a significant cause of operating room blood product waste was units that were stored and/or returned outside the required temperature range established by the American Association of Blood Banks (AABB), according to the abstract of a presentation at the 2016 annual meeting of the International Anesthesia Research Society (IARS). The committee was inspired by a Mayo Clinic study of a blood transport and storage initiative that significantly reduced median monthly red blood cell and fresh-frozen plasma waste and saved approximately $9,000 per month after replacing existing storage coolers and improving the educational cooler label. The UF College of Medicine committee decided to start small by testing the impact simply changing the label.
According to a recent Anesthesiology News article. Ashley Screws, M.D., an anesthesiologist at the UF College of Medicine and UF Health Shands Hospital in Gainesville, Florida, worked with her team on the visual, icon-driven label design to replace the previous text-heavy label that was often ignored. The new labels were implemented hospital-wide in September 2015.
A $20K Savings In Just Five Months
Dr. Screws and co-investigators, Jeffrey White, M.D., and J. Peter R. Pelletier, M.D., compared data for blood product waste collected during October/November 2014 with data for blood product waste collected during October/November 2015. During October/November 2014, 235 product units were marked for waste, 25.5 percent of which were returned to the blood bank outside of regulation temperature range, and the total calculated cost of this waste was $9,167, per the abstract ($8,717, according to the Anesthesiology News article). During October/November 2015, after the new transport cooler labels were implemented, only 149 blood product units were wasted and only 10.7 percent of those were returned outside of temperature range, a $3,178 total calculated waste cost – a $6000 ($5,500) year-over-year (YOY) savings for those two months. The number of lost platelet units, the most expensive of the blood products, decreased from six units during October/November 2014 to only two platelet units during October/November 2015.
During the presentation, Dr. Screws reported the researchers also compared blood product waste collected December 2014–February 2015 with waste collected December 2015–February 2016, according to the article. During December 2014–February 2015, 99 product units were marked for waste, of which 34 percent were returned to the blood bank outside of regulation temperature range – a total calculated waste cost of $21,987 for the quarter. During December 2015–February 2016, only 32 blood product units were wasted, of which only 11 (34 percent) were returned outside of regulation temperature range at a total calculated waste cost of $8,155 versus the same period the prior year – a savings of nearly $14,000. Including the $6,000 savings during October-November 2015, that’s a $20,000 YOY savings over five months, even though large transport coolers in which massive transfusion protocol blood products are dispensed did not have the new labels until December 2015.
The hospital plans to build on this success by creating new labeled bags for platelet transport to prevent them from being placed inside coolers improperly and an electronic medical record reminder to encourage proper and timely blood product return.