Viability of Auto Donor Program

[jhaig]

Has anyone out there recently dropped their autologous donor program? We are evaluating our program and trying to decide whether or not it is still cost-effective. For about 6 or 7 years the numbers of patients giving their own blood for surgery has dropped off considerably. In 2001, we collected 217 auto units. So far thru July of 2008, we've collected only 27. This has been due to a combination of several things:

- reinfusion devices to recover shed blood post-op

- it's a real money loser

- it's time consuming

- number of surgeries requiring auto units decreasing

- trying to stay in compliance with increasingly ridiculous FDA standards (we just got dinged on thermometer QC ?!?)

Any advice on how we can more effectively evaluate our program would be appreciated.

If we can save money and keep the FDA out, that's a win-win for us.:cool:

[Mary**]

When we stopped our program many years ago, a representive from our blood supplier and I visited the doctors offices that ordered autologous units drawn and gave them the forms and information they needed to have the units drawn at the blood center. To my surprise it was well recived.

[bbbirder]

We stopped collecting Autologous units about 2 years ago, for all of the reasons you have mentioned. Our blood supplier visits once a week and collects autos, therapeutics, and (occassionally) directed and regular donors.

We don't regret dropping this at all.

Linda Frederick

[Likewine99]

We've worked with our blood supplier and had our physician peer review committees educate physicians on the practice of moving away from auto units.

We tied it to dollars that are not recoverable when the unit is not used, we don't draw them at our place, the 6 we've had so far this year were drawn by ARC and 5 were given.

If a doc requested autos or directeds our med dir sent a letter asking why?

Soooo glad we've moved away from this! Huge cost savings not couting the time:highfive:

[jhaig]

I don't even want to have our reference lab collect the units, I just want the program gone. As a patient service, it's just not being utilized and I don't see it increasing in popularity any time soon.

I agree that putting it to administration in terms of money is the way to go.

[ShowDogDad]

Hey there,

Autos comprise about 1/2 of our donors here. (Approx 10-15/day.) We have a big ortho institute across the street, and auto donation is a routine part of thier pre-op procedure. There is no way that we could ever consider dropping autos.

[Peggy]

wow show dog, what is your discard rate of auto's? Our hospital does not collect autos, we receive under 10 units a year. This was cut by our Medical Director speaking with the physicians. The bottom line, most were not getting transfused, it was simply a habit of practice for some physicians. The practice here has changed, auto collection seems outdated and the cost savings is an added plus.

[ShowDogDad]

Can't answer that for sure. We just collect at this end of the hall. Issue is done from the other end of the hall. Last time I asked, I think they said the discard rate was around 15%. The biggest change for our collections is that they are only ordering one unit most of the time now instead of the 2 or 3 units they used to order.

[jhaig]

wow show dog, what is your discard rate of auto's? Our hospital does not collect autos, we receive under 10 units a year. This was cut by our Medical Director speaking with the physicians. The bottom line, most were not getting transfused, it was simply a habit of practice for some physicians. The practice here has changed, auto collection seems outdated and the cost savings is an added plus.

As of right now we have wasted 66% (23/35) auto units collected. Almost all of these patients were either knee or hip replacements. I did a study 2 years ago involving the rate of transfusion in relation to the patient's pre-donation Hct level. In patients that had a pre-donation Hct of 40% or greater, 92% of their auto units were discarded. This fell on deaf ears and the program's numbers have continued to decline.

Is there any incentive that I don't know about for administration to hold on to a program that is not viable anymore? Other than it's one less patient service to offer, when do we cut the cord on this thing?