1. NAC Meeting Cheryl Doncaster / Kathryn Webert Utilization
November 2017

2. Agenda Items Reference Documents System Wide Platelet Discards
‘Thawed not used’ Plasma Discards
Reference Documents
Platelet System Outdate Report
Fresh Component Disposition Trends (including SD Plasma)
NEW Hospital Specific PPP Trend Reports

3. System Wide Platelet Discards

4. Extended Shelf Life

5. Utilization Update (post extended shelf life implementation)
Hospital response to platelet extended shelf life implementation is varied and not completely known yet.
Platelet disposition data from hospitals is now being reported for the month of October
Hospitals are focusing on data monitoring and adjusting standing platelet orders as appropriate. In some cases, the number of deliveries/wk have decreased.
# Hospitals that have adjusted standing orders
Total platelets removed from standing orders /week 11
34 units

6. Process Improvement and Redistribution
Initiative
System Impact
Decrease Discards
Impact production/ collection plans
Decrease Costs
Customer/Patient Benefits
Extended Shelf Life
Yes – 30%
Yes (# discarded)
No (process costs)
Longer shelf life
Process Improvement and Redistribution
Yes – 60% (including extended shelf life)
Yes
Yes (redistribution for system and # discarded)
Enhanced service
HLA / HPA No
Optimized process and provision of effective product
APLT Reduction
Yes (# discarded and process costs)
Shift towards less expensive product
PAS
Yes - Less desirable bld grps will not be thrown out
TBD
Universal platelets
Plasma for fractionation
Non-destructive QC
Yes - extra plts available
Chagas
Yes – extra 2000 units available /yr
Transport Bag (Hospitals): C4I funded
Yes – extra plts available
Investment in customer initiative to improve system performance
July 26, 2017

7. Platelet Program Focus Area Initiative Objective Timeframe
Platelet Shelf Life Optimization
Extended Shelf Life
Extend the shelf life of platelets to 7 days
Implemented: August 14, 2017
Process Improvement
Optimize processes: Inventory management, ordering practices, timing of plt production and release to hospitals
Start discovery work: January 2018
Redistribution
Leverage logistics routes, do more to assist the system
Platelet Apheresis Dependency
HLA / HPA Requirements
Optimize availability of product for patients, provide demand data to support future reduction in apheresis collections
Implemented: July – October 2017
Apheresis Reduction
Reduce the system dependency on apheresis platelets
Implemented: September 2017
Multi-year slow and controlled effort
Platelet Additive Solution (PAS)
Universal platelets
Approx. 3 years
Testing
Non –destructive QC
Retain units in inventory
Production studies scheduled to start:
June 2018
Chagas
Test at risk donors once, retain units in inventory
Minimum 18 months
Utilization / Reporting
Supportive / Ongoing

8. Actuals (*incomplete hospital data) Estimates (in progress)
Nov 15, 2017
Initiatives
Stakeholder Consultation (Q4)
Extended Shelf Life (Q2)
NAC Recommendations ?
Apheresis Reduction (Q2)
Distribution / Redistribution Improvements
Non- destructive QC
PAS
Chagas Testing
Blood System
2016 – 2017
Total plt produced
131, 290
134, 527
132, 471
133, 300
127, 396
Apheresis
Pooled
40, 013
91, 277
40, 983
93, 544
35, 000
97, 471
30, 000
103, 300
25, 000
102, 396
Total plt discards
37, 329
36, 105
15, 058*
31, 989
29, 300
19, 396
-outdate discards
-in date discards
26, 489
10, 850
24, 810
11, 295
10, 836*
5, 567*
21, 189 (mid yr 30%)
10, 800
18, 500 (full yr. 30 %)
10, 596 (60%)
8, 800
CBS
14, 509
14, 306
7, 354
13, 602
13, 145
9, 801
4, 557 (17%)
9, 952
3, 854 (15.5%)
10, 452
2, 165
5, 189
3, 602
10, 000
3, 145
1, 801
8, 000
Hospitals
22, 830
21, 799
9, 149*
18, 387
16, 155
9, 595
21, 932 (83%)
898
20, 956 (84.5%)
843
8, 771*
378*
17, 587
800
15, 355
8, 795
Transfused
94, 589
98, 823
46, 942*
100, 482
104, 000
108, 000
30, 391
64, 198
31, 234
67, 589
14, 523*
32, 419*
Source data:
Hospital = BOA0831
CBS = BOR0401
Fiscal baseline data
Grey font
Estimate of platelets produced = Transfused (guess) + total discards
Total discards = estimated outdate reduction (J. Blake modeling) + indate discards (guess)
Estimate of platelets outdated at CBS and Hospitals = total outdate estimate split between both. Hospitals = 83%, CBS = 17%
Estimates are conservative and do not take into account full impact of some initiatives.
- more work is required to better understand these impacts.

9. ‘Thawed not used’ Plasma

11. 2014 – 2015 = 4, 271
2015 – 2016 = 4, 208
2016 – 2017 = 4, 363
(excludes BC/Y)

13. Discussion points:
Overall, the amount of plasma discarded as ‘thawed not used’ is consistent year to year, however; some jurisdictions are trending down, while others are going up. Are there specific practices influencing this?
‘Thawed not used’ plasma is a specific plasma disposition category. Should the data be combined with ‘outdate’ data (>1 yr) for analysis?

14. NEW Hospital Specific PPP Disposition Report
Excel based
12 month hospital performance metrics
36 month trend graphs for select products
Highlight usage trends and cost over time
Available to hospitals in December 2017
Online via the ‘Trend Report’ area within the Blood Component and Product Disposition System