Reducing wastage of blood and blood products

Blood is a precious resource generously donated by non-remunerated donors in Australia yet, the collection, processing, testing and distribution of blood and blood products incur significant costs. Nowadays the cost is clearly identified on the product label, which is indicative of the manufacturing costs. Details of the costs can be found within the National Blood Authority’s National Product Price List (external site).

Blood and blood products are used in hospitals across Australia every day to save lives. A certain level of discards of blood and blood products is both inevitable and appropriate to ensure that products are available where and when they are clinically necessary. We face additional challenges in WA with our geographical remoteness and seasonal weather changes.  However, there is a proportion of discards of blood and blood products that is neither inevitable nor appropriate which is defined as wastage. In 2017/18 WA red cell discard rate was 4.9%, significantly higher than the national average of 2.2%.

Minimisation of the wastage of blood and blood products is a key requirement of the Statement of National Stewardship Expectations for the Supply of Blood and Blood Products, endorsed by Australian Health Ministers in November 2010, and National Safety and Quality Health Service (NSQHS) Standard (Standard 7, Blood Management). The National Blood and Blood Product Wastage Reduction Strategy 2013-17 (the Strategy) has been developed by the National Blood Authority (NBA) to reduce the unnecessary wastage of blood and blood products (external site).

The Office of the Chief Medical Officer (OCMO) initiated the WA Blood Discard Reduction Project in late 2018 to understand the root causes for WA’s disproportionately high rate of red cell discards, whether these root causes could be addressed and to develop appropriate strategies to rectify them.

Key outcomes from this project include:

• Extensive stakeholder engagement with public, private, metropolitan and rural Approved Health Providers (AHP’s)
• Improved Department of Health (WA) understanding of current inventory management and stock rotation practices by WA AHP’s
• Identification of significant differences in reasons for red cell discards between Metropolitan and Rural AHP’s
• Identification of challenges and barriers to stock rotation by WA AHP’s
• Addressing of data issues related to the accuracy and level of detail of red cell discards
• Increased awareness of avoidable red cell discards by WA AHP’s
• Improvements to inventory and stock rotation practices by WA AHP’s
• Improved engagement between Hospital Executive, Hospital transfusion committees and AHP’s