Blood Shortages Working Group October 2015 NAC Meeting

Historical BSWG membership

Review of BSWG membership Current Blood Shortage Working Group CBS representatives NAC representatives Lindy McIntyre - lindy.mcintyre@blood.c Dr. Brian Muirhead -muirhead@mymts.net Rick Trifunov - rick.trifunov@blood.ca Dr. Debra Lane - debra.lane@blood.ca Dr. Ted Alport - ted.alport@blood.ca Dr. David Anderson – david.anderson@cdha.nshealth.ca Elaine Ashfield elain.ashfield@blood.ca Lisa St. Croix lisa.st-croix@blood.ca Dr. Lakshmi Rajappannair - lakshmi.rajappannair@horizonNB.ca Michelle Rogerson - michelle.rogerson@blood.ca Dr. Lucinda Whitman - lucinda.whitman@easternhealth.ca and Amanda Cullen – Amanda.Cullen@blood.ca Lucinda.whitman@mun.ca Provincial Territorial Dr. Susan Nahirniak - susan.nahirniak@albertahealthservices.ca (CHAIR-BSWG) Wendy Peppel – wendy.peppel@gov.mb.ca Shelley Stopera – Shelley.Stopera@gov.mb.ca Daphne Osborne – daphneosborne@gov.nl.ca Marina Hamilton - marina.hamilton@cdha.nshealth.ca Ministry of Health Quebec -Liaison Dr. Vincent Laroche - vincent.laroche.cha@ssss.gouv.qc.ca Samantha Cassie - Samantha.cassie@gov.ab.ca CSTM representative ?

Changes to National Plan - updated as of October 8th, 2015

Highlight of Updates 1) Communication requests 2) Committee clarity 3) Inventory phases 4) Update of the history of shortages in Canada

1. Communication - Requests Request for a standardized template from CBS when dealing with local temporary shortages Request for a standardized communication document for dealing with patients / families in amber and red phase

2. Committees (Section 4) Clarity provided regarding top down and bottom up activations Updates for changes to Titles / designations

3. Inventory / Phases

Phases - Terminology Green Phase Advisory Alert versus Advisory implies that CBS inventory levels are low with respect to a particular blood component and that all hospitals need to determine their inventories and the likelihood of crossing into Amber or Red Phase .  Alert versus Advisory Will only use Advisory on all communications

Phases - General Inventory Major revisions in Section 3 Revised section 3.1 to include the concept of Inventory Indices, reporting of daily inventories

Phases - General Inventory Major revisions in Section 3 New table in 3.1.1. added to provide visualization of Green vs Green Advisory

Phases - General Inventory Major revisions in Section 3 Tables in 3.1.5 All except platelets- Addition of number of units translating to DOH broken down by blood group Plasma – further broken down by AB and non-AB

Phases - General Inventory Table in 3.1.6 Examples of Inventory indices using hospital data

Phases - Allocation Major revision to section 3.1.7

Section 6 – Specific Actions Updates through all levels regarding the development of ADRD, Inventory Indices and Minimal inventory calculations Processes for reporting daily inventory Incorporation of best practices to “level” indices Improve communication Risk management assessments for “holding facilities

Criteria / Guidelines for Inventory Utilization

Platelets - Splitting Does “splitting” require registration with Health Canada as a modifying process? No, this is considered aliquotting. Possibility for CBS to provide platelet aliquots? Preliminary research has been done but production has not yet been validated. Decision not to provide splitting information in Plan as an appendix but to have sample SOPs or job aides on the NAC website for sites to use if they are interested.

Recommendation from BSWG For NAC to accept the National Plan in it’s current version as a submission to the CBS PT Blood Liaison Committee as a final version subject to translation.

Recommendation (s) from BSWG’s Inventory Subcommittee Recommendation (s) from BSWG’s Inventory Subcommittee ? Approved by NEBMC meeting in Sept Hospitals should conduct inventory submission exercises on a quarterly basis. Proposed for April, July, October and December of each and every year. A rolling twelve (12) month disposition reporting period will be used to calculate ADRD. These exercises will aid to further refine the inventory indices corresponding to phases of inventory availability.