Blood Center hours away

[Barb Thompson]

I would like to know how one deals with a blood center that is hours away.  In the interest of saving money, my corp wants to switch from a center that is 15 miles away to one that is about a 4 hour drive away.  How do you handle stats? reference work? deliveries? blood drives? Insights, please!

[Auntie-D]

I worked where the nearest one was a 4 hour drive away.

-In bad weather we had a ministry of defence helicopter on standby.

-shipment containers had dater loggers as they were only validated for 4 hours.

-We held only AB plasma so it could be used for anyone.

-On 2 occasions the emergency delivery got rerouted by the medics to the airport for transport 'to save time' - along with the stock blood grrr

-we couldn't properly offer a MHP due to not holding platelets and could only deal with 2 bleeders at a time

-the 72 hour transfusion cutoff sometimes became an issue for our haematology patients with antibodies

All in all it was pretty horrific but was a necessity as it was the nearest. I certainly wouldn't choose this if there was one nearer...

[tbostock]

4 hours is pretty far away...lots to consider as mentioned above. You would need to boost your inventory, and I would push for at least daily deliveries. It can be done but in the interest in saving money (I've gone through this a few times) a blood supplier is not like your vendor for test tubes. They need to have a strong focus on customer service and you need to form a trust with them (and them with you) for it to be a successful partnership.

[Mabel Adams]

It really depends on your means of transportation.  I have never been closer than 2 hours from my supplier, now am about 3.5 hours (more if the passes are snowy) and have been 5.5 hours away.  In the latter case, all but very routine shipments were flown and we kept a large stock of blood products.  Platelets were always the biggest problem.  When we didn't routinely stock platelets, they sometimes had to charter a flight at great expense.  This was ~20 years ago in Idaho.

 

Now, at 3-4 hours away, we get routine shipments by nightly courier, emergency shipments by air.  If the flights won't be fast enough, they dispatch a courier immediately and if it is really dire we use the State Police.  We stock several platelets and have to rotate a lot of them back to the big hospitals in Portland so they don't go to waste.  We have to plan pretty far ahead.  When a massive transfusion starts we have to look at whether we need to get more products started on their way 3-4 hours before we might need them.  We try to stock enough blood to care for 2 group O patients using 10 RBC per hour, somewhat less after the first hour (I have some assumptions I used for planning but don't remember all the parameters exactly).  We can borrow units from the surrounding small hospitals using a local stat courier service but we probably can't get more than about 10 O's from them total.  That could buy us another hour for one patient or half an hour for 2.  We pray they aren't both O and both bleeding 10 units per hour for more than an hour. We are a 261 bed level II trauma center in Central Oregon.

 

Our supplier has a draw site in town.  We don't send a lot of reference specimens but we either fly them or send them with the nightly courier depending on urgency. Don't forget to plan for disasters too.  

[Barb Thompson]

Well, they had a meeting and we expressed our concerns, so they decided to stay with the local blood center. Logistically, switching to a blood center that was 183 miles away was just not going to work for us.

[Malcolm Needs ☆]

Maybe it would have been a good idea to consult you first?????????????!!!!!!!!!!!!!!!!!!!!!!!

[Dr. Pepper]

Good for you, Barb. A victory for logic and improved patient safety over the nefarious forces of penny-pinchers - how refreshing.

[John C. Staley]

Just a little food for thought.  Out here in Big Wonderful Wyoming if you are within 3 hours of a blood center it is something to not take lightly.  My suggestion, if the issue comes up for others would be to sit down with the blood center staff and find out how others do it.  They most likely work with folks even further away than you.  You really very seldom need to re-invent the square wheel.  I'm kinda lazy and I love to learn from the experience of others. 

[AMcCord]

Our blood supplier is 150 miles away - we've worked with this scenario for decades and we've never had a patient bleed to death because we couldn't get blood for them. Once in awhile it can get a little exciting, but we do the things that Mabel talked about doing and, thankfully, our delivery options have increased over the years. We get one major red cell delivery weekly (yes, we stock a lot of red cells) with rotation of platelets Monday thru Friday. We can order additional red cells with the platelet restock and we have access to a commercial courier for a late evening pickup at the blood center Sunday thru Thursday with delivery the following midmorning. Our neighbors are quite small, so it is us vs the world. It works because we have an excellent relationship with our blood supplier. If we are in a serious bind, they will figure out something and make a special delivery run for us if necessary. If the weather forcast looks grim (and we do get blizzards and ice that can close the highways for 24-48 hours), we think about the special needs folks we could see, plan for bleeders and push up our supply before the weather hits.

 

It's always kind of interesting to be inspected by people who are used to having their blood supply less that 15 minutes away. Freaks them out ! But truly...it's not the end of the world if the supplier will work with you. 

[bbbirder]

Our blood center is 2 hours away, and like others have said, our biggest problem product is Platelets.  We keep some on hand, but sometimes run out and need to get shipments off schedule.  Another product difficulty is when you need to order those 'rare' antigen typed units.  How many to get is always a game.

 

Another impact is your ability to ID complex antibodies.  We rarely send anything to our reference lab, just because of the time and logistics.  So, even though we have all generalists, we are pretty good at ABID.

[AMcCord]

Another impact is your ability to ID complex antibodies.  We rarely send anything to our reference lab, just because of the time and logistics.  So, even though we have all generalists, we are pretty good at ABID.

 

Excellent point. All generalists but me. We only send the ugliest ABID samples to reference. They go by the same courier that rotates our platelet stock and with the weekly delivery courier. If we are desperate we pay for a special courier run (doesn't happen often).