Background/Case Studies: Red blood cell (RBC) wastage represents a significant concern in hospital blood management, affecting both finances and patient care. This study analyzed the extent of RBC wastage at UF Health Jacksonville Hospital and identified contributing factors to guide quality improvement initiatives.
Study
Design/Methods: Data on monthly RBC wastage counts between May 1, 2023, and November 30, 2024 were retrospectively collected for different departments from the hospital's blood bank. Other blood products (Plasma, cryoprecipitate, and platelet units) were excluded from the study.
Results/Findings: During the study period, a total of 88 (0.7%) RBC units were wasted. Departments with the highest wastage included the Medical Intensive Care Unit (MICU) and Operating Room (OR), each accounting for 12.5%, followed by Neonatal Intensive Care Unit (NICU) (10.2%), Surgical Intensive Care Unit (SICU) (9.0%), and Cardiac Care Unit (CCU) (6.8%). All other department accounted for 49% of the total wastage. The peak waste rates were observed during May 2023 and June 2024 (Figure A). Our analysis revealed that the most common causes of wastage were temperature control failures (15.9% of cases), followed by consent-related issues (13.6%), transport losses due to malfunctions in the pneumatic tube system (9.1%), and order cancellations without adequate justification (7.7%). Miscellaneous causes, including but not limited to equipment failures, spiked but unused units, and incorrect blood type issuance, accounted for the remainder. The financial loss due to this wastage was estimated at approximately $22,000, without including the extra costs related to administration, equipment repairs, and other operational issues. Addressing the problems like temperature mishaps and consent issues could minimize the financial loss for the hospital and reduce patient’s burden.
Conclusions: This analysis shows that RBC wastage is mainly due to preventable causes such as consent-related issues and temperature control failures. To minimize RBC wastage, collaboration between the blood bank and clinical departments must be strengthened. Department-specific strategies include verifying consent prior to blood release in the MICU, improving temperature monitoring systems in transport coolers for the OR, and utilizing smaller aliquots for neonatal transfusions in the NICU to reduce waste. General recommendations involve conducting regular workshops on transfusion protocols with an emphasis on consent documentation, upgrading the hospital’s transport systems to mitigate losses, and improving temperature monitoring and storage practices. Ongoing improvements will require continuous tracking and staff training to ensure best practices are followed. By implementing these steps, we can lessen waste, make better use of resources, and enhance patient care.
