With the current economic down turn I'm sure many healthcare organizations are in same position as ours. I have been asked to think of anything that will save money without compromising quality of care. I just want to start a thread of ideas on how Blood Banks specificaly can achieve these demands from our administrators. For example: we are exploring the option of stopping the use of the GEL method for unit retyping by reverting back to the TUBE method. What are some things you or your Blood Bank have done recently to save money?

We decreased our FFP inventory by 50%, since it's not returnable we pay for it upfront. We moved to 5 day plasma a couple of years ago, that decreased FFP wastage.

My hospital purchasing group gets better pricing from Ortho than Immucor. I d/c'd the Immucor 20 cell panel for selected cells and went with an Ortho 11 cell one. Based on my contract pricing that is saving me $600/month.

It is cheaper for us to use gel cards than tube reagent, we are doing all ABO/Rh in gel cards unless it's super stat. We're in the process of validating antigen typings in a gel card to save antisera. We currently do anti-Fya in a gel card, will move the RT ones to gel card as soon as I can get the procedure written.

We're definitely on a no OT kick, we lost a FT night shift generalist and we are just going to "suck it up". We've crosstrained almost eveyone on days and eves to work at least 2 depts, if we have a call in we just play "musical techs" and cover the benches.

At our place the bottom line is The Bottom Line!

We implemented Kell, DUffy, Kidd and S, s typing by gel using traditional antisera. It will save you lots of money particularly with anti-sera costing you > $100/vial. Think about if 3 mL vial is costing you $1000---1 drop for tube method costs you $16, compare to you will be using only 25 ul for your gel testing will cost only $8/test plus the cost of one well of IgG(~$1).

Our LIS system is not user friendly so we were running control for antigen typing every day several times(each techs used to run their own control(...we develop a form so we do not duplicate controls for antigen typing.

Traditionally, laboratories are very well managed and run as efficiently as they can -- transfusion services are no different, and most of the "easy pickings" are already implemented. Reagents are usually dictated by buying group contracts and staffing levels are proscribed by the personnel budget. The cost of validation sometimes precludes any changing the little stuff that can add up to something significant.

Sure, we can delay some purchases, watch inventory closer, and re-evaluate some costly procedures in the short-term, but we have to have product available when needed. It's usually a trade-off between machines/material and manpower, and with MT availability and reimbursement levels where they're at, the best we can ever hope for is break-even.

Your only chance for breakthrough cost savings is process redesign and slaughtering some of your sacred cows, while still being able to sleep at night.

Another option is to implement a Blood Conservation Program. We now mandate the use of transfusion alternatives before using blood products. We reduced our red cell usage by 50% and saved over $250,000 the first year. However, now we do such a "good job" that we are budgeted less and less for blood each year, so savings are not apparent after the first year or so.

I retired and they are paying my replacement less money. I'm sure that made some one happy.

The verdict is still out on the impact of this on quality.