(P-IV-6) Platelet Sharing Between Community Hospitals and Tertiary Care Medical Centers: A System-Wide Approach to Reducing Platelet Waste and Improving Patient Care

Background/Case Studies: Maintaining a reliable inventory of apheresis platelets (AP) while minimizing waste from outdating is a common challenge, especially for smaller community hospitals. To address this, a novel platelet distribution strategy was implemented across a health system comprising 23 hospitals, including smaller community hospitals (SCH) and larger tertiary care medical centers (TCMC). This system facilitated inter-hospital sharing of AP units, improving overall utilization and reducing waste. As a result, SCHs were able to consistently maintain an inventory of approximately two AP units without a significant increase in outdating or associated costs.

Study

Design/Methods: A creative platelet sharing (PS) and transportation system was implemented in collaboration with the blood supplier to optimize apheresis platelet (AP) distribution across the health system. The primary objective was to reduce reliance on supplemental and emergency AP deliveries while enhancing inter-hospital sharing. Platelets were transferred during standing order deliveries, following a predetermined route and schedule. Delivery routes began at smaller community hospitals (SCH) and concluded at a tertiary care medical center (TCMC). On average, approximately two AP units were delivered daily to each SCH, depending on local need, and any units not transfused from the prior day were retrieved. This process was repeated at each SCH along the route, with all retrieved platelets ultimately delivered to the TCMC as the final stop. The AP units arriving at the TCMC typically retained at least two days of shelf life prior to outdating. This system ensured SCH maintained access to platelets for urgent use while minimizing waste by allowing unused units to be transfused at the TCMC before expiration.

Results/Findings: Review of the PS process demonstrated significant benefit to smaller community hospitals (SCH), with routine maintenance of an apheresis platelet (AP) inventory supporting urgent transfusion needs. In 2023, the health system transfused over fifteen thousand platelet units and maintained an AP outdate rate of 3.7% (Table 1). This low outdate rate contributed to substantial cost savings while ensuring AP availability for urgent transfusions. Additional savings were realized through reduced emergent platelet delivery charges.

Conclusions: The novel PS process has led to improved platelet availability at smaller community hospitals while maintaining a low rate of apheresis platelet (AP) waste across the health system. Further reductions in AP waste are anticipated as the process is streamlined and improvement opportunities are identified. Given the recent trend of smaller community hospitals (SCH) joining tertiary care medical centers (TCMC) to form integrated health systems throughout the United States, this approach may offer a scalable model for enhancing platelet availability and minimizing wastage due to outdating in similar settings.