NAC Update: British Columbia October 2015 Dr. Doug Morrison BC Provincial Blood Coordinating Office (PBCO) Dr. Bob Coupland BC TMAG

Discharge Abstract Database (DAD) & CTR Data Linkage Project purposes To investigate the following questions: Which hospital procedures or specialties use blood and blood products? How much, if any, variation is there in blood use within clinical categories, diagnostics, interventions, and procedures? How much, if any, variation is there in blood use within and between services in regional and hospital level? How much, if any, variation is there in blood use in the procedures and specialties over time? Which hospital procedures and/or specialties use the most red blood cells? What is the impact of transfusion practices on mortality rates, hospital length of stay, or hospital acquired infections?

RBC Audit Pilot Project Sub-project from the DAD & CTR data linkage Pilot with Interior Health Based on DAD data, targeted audit AABB audit tool

IVIg Working Group 2 projects: SID IVIG/SCIG use for SID/PID conditions, and Metrics for both patient outcomes and effectiveness of UM program SID

iCHIP Permission obtained from BC HIPSC (Health Information Privacy and Security Council) to expand iCHIP Clinical Module access to all Transfusion Medicine physicians to ensure timely access to relevant patient information Mobile Application STRA (Security, Threat and Risks Assessment) in progress Next steps include posting to Apple App Store and Google Play Store.

Hospital Inventory Optimization Model Collaborated with Fraser Health which represents urban, large hospitals’ blood demand, along with, Northern Health which represents geographically vast with remote smaller hospitals’ demand The model simulated each hospital in a network individually before calculating overall metrics at the end. The metrics included:  outdate rate shortage rate average age of blood at the time of transfusion blood substitution order frequency

Conclusion Reduce ordering levels Modify transshipments Best Changes Reduce ordering levels Modify transshipments Possibilities Infinite combinations of policies We’ve only scratched the surface Next Steps Add more networks Create new policies to test

CBS IT Outage – Sep 15, 2015 Vancouver Center unable to end-label components STAT orders only Lessons learned Platelets were the major issue Lack of downtime procedures for end labelling Regional shortage that may have benefited from a National/Western response Earlier activation of import

Activities relating to New CBS Insulated Shipping Container CBS/PBCO Joint Educational Symposium Sept 24, 2015 Concerns expressed by hospital technologists TMAG has heard TRG concerns, such as: Ergonomics and Occupational Safety given size & weight of all but the platelet box Trolleys & mechanical lifters Distribution of blood supply within HA’s Hub hospitals - satellite hospitals (supply & redistribution) Patient transfers that require blood Facility renovation to accommodate storage of empty boxes Training/education of staff re transport & multiple packing configurations BC Redistribution Program Purchase of validated boxes for redistribution within and outside HA’s

Other Projects Donor Selection for Sickle Cell Anemia – TMAG Recommendations Hereditary Angioedema TMAG Recommendations TMAG Recommendations for Acute and Long-Term Prophylaxis Individual Careplan (expedited care in ER department)