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

2. 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?

3. 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

4. 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

5. 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.

6. 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

7. 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

8. 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

9. 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

10. 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)