managing blood inventory for small hospital

[larevalo]

Is there any method or procedures or formula in eliminating the high rate of expired units in our blood inventory.And what is the benchmark?The size of our hospital is 120 bed capacity.

[KKidd]

I have never seen a formula. I would take the following things into account:

How far are you from your blood center?

What is your average usage?

What are the BLood types of your patient population?

I am from a hospital of about the same size as yours. We are approximately one hour from our blood center. Our normal stock level is 24 O+, 24 A+, 4 B+, 2 AB+, 6 O -, 6 A-. Most of what we outdate are AB+ and we get credit for them.

We also keep plasma 6 O, 6 A, and 8 AB; 10 cryo.

I hope this helps.

[jhaig]

There isn't any benchmark that I know of that relates to rate of expiration of RBC units. It depends upon your institution's usage, patient population, and other factors.

A couple of questions first:

1) How big is your institution and how much of each blood type do you keep on hand?

2) Are you expiring more of a certain blood type?

3) Does your supplier credit you for units that expire at your facility?

We are a 290 bed facility that transfuses around 2500 units a year. We expire less that 50 units annually. At this time, we do not stock group AB or

B negative since patients with these types would receive alternate groups. Our rate of waste would increase if we kept rare types like B neg or AB on hand.

[krichards]

We are a 350 bed facility, and we do not keep AB or B neg on hand either. Actually, do to lack of demand, our blood supplier does not keep these on hand either.

Our local blood supplier serves a large geographic region with a mostly rural population. Many of the facilities they supply are <50 beds. The solution our area has found has been to supply the smaller outlying facilities with fresh stock every two weeks or so. The unused, shorter-dated units are brought back, re-processed, and then delivered to the larger hospitals (usually us), where they can be used before expiration. We only rarely have a unit expire on our shelves.

You may want to talk to your local blood supplier to see if a similar arrangement can be worked out.

[David Saikin]

We rotate out our units also. We are a 40 bed facility and an overstock hospital for northern NH/Vt. We get a routine restock once every 2 weeks. Our shortdated units are transferred via the Red Cross on our shipment date. They go to larger facilities in the southern part of our state. Haven't outdated any units this year. The system works well for us.

[bbbirder]

We are about the same size as you. We transfuse about 2800 RBCs/year. We keep a pretty big inventory of blood, because we are 2 hours+ from our supplier and along a busy interstate with frequent accidents. We can return RBCs (but almost never do) and PLTs (these are exchanged out 3x per week).

Our stock level for RBCs is at 150 of various types, reorder levels vary. We also keep about 100 FFPs and 20-30 Cryos (Cryos almost always outdate.)

LF

[larevalo]

Thanks,the standing order of you blood components is almost the same as ours.But how you were able to got those figures for each ABO group?

[larevalo]

Thanks for your response,Our facility is just 150 bed capacity and most of the unit expired were mix A and O group.We keep 20 Units of O FPRBC as our standing order including those for emergency cases.We are almost 50 km away from the Donor Unit and our new director change the policy not to return the nearly expiry unit to Donor Unit,bec. he wants to monitor our new internal indicator which is the expired units.We follow the equation used in managing blood bank inventory.But to get the bench mark for expired units is still a question to me.

[KKidd]

Thanks,the standing order of you blood components is almost the same as ours.But how you were able to got those figures for each ABO group?

I would love to be able to answer your question. I have worked at this facility for 30 years and our inventory has remained at almost the same level the entire time.

[Eagle Eye]

We are level1 trauma center & transfuse ~10000 red cell every year. Our outdates is <0.5%. Our supplier do not give us credit.

[AMcCord]

Every few years, our blood supplier takes a look at what we order and use over a period of a year or so, then calculates an average number for each red cell type for weekly orders. I think they add a fudge factor of a few percent to account for heavier use. Then they send us the list as a proposed standing order. If we don't like their list, we can ask them to change the numbers a bit to suit us. There's a little give and take on both sides and the numbers seem to work well for us. We do have to order special needs through the week ( antigen neg, irradiated, etc.) and if we are using heavy amounts, we have to order midweek, but not frequently. We return very few red cells - only Rh negs as a rule, if our supplier needs them and outdate very few. If your supplier won't/can't supply those numbers, can you pull your own numbers and check your average use over a year or two?

We are 150 miles from our supplier, so this is an important thing for us, too.