Outdate Rate

[armymt2002]

Hi,

Can someone tell me how to calculate the outdate rate of RBCs? I am new to being a supervisor and this is my first time doing the monthly reports. Thanks.

[Lcsmrz]

There are many ways to derive the value, but the most common I've seen is the number of components discarded for any reason over the number of components received (or over the ave daily inventory). Many facilities have a monthly spreadsheet for basic inventory tracking (begin inventory + units rec'd - units transfused - units returned to blood center - units discarded = end inventory) and follow various numbers to indicate how well they are handling their products.

The value of the ratio is to determine if there is a trend or change in wasting units, esp platelets or thawed FFP. Even if you fanatically manage your inventory, you'll throw a few red cells away ever month, and if you are required to have platelets on hand at all times, you'll outdate some of them also. But blood products are expensive, so the transfusion committee must weigh availability and TAT against outdate potential for the service level of the facility.

One place I worked discarded HALF of the platelets we were required to stock and that was considered acceptable by the medical staff, due to the acuity of the patients and the procedures they were undergoing.

[armymt2002]

Thanks for that information. What the person who did this before me did was to take the total available minus the transfused and divide that by the disposed of. Our outdate rate is almost 1/2 of what we transfuse so I am going to see if we can cut that down.

Kristine

[Lcsmrz]

You may want to consider different discard rates for different components.

With RBCs, you may be carrying too large an inventory or too many of the rarer groups -- and make sure your SOP allows giving compatible units (esp O+, O=) without jumping through hoops! We stock 2.5 weeks worth of average usage, respresenting 99% of our historical maximum usage; our blood center is 30 mins away for the remaining 1%.

With FFP, it may be a communication thing. "Crossmatching" FFP does not always mean thaw and have immediately available. The 30 min wait to thaw is sufficient for most of our docs. And consider the "thawed plasma" option that is gaining popularity in Indianapolis, IN. Your transfusion committe may help here.

With platelets, your service level may require you to stock them, even with no foreseeable use. With an active Oncology service, I've seen discard rates below 5%. At a cardiac-only facility, we threw away half, since we had no cancer patients to keep the inventory turning.

Good luck!! Inventory control takes a lot of effort, but the payoff is financially worth while.