Stop the ‘bloody’ waste: How collaboration, competition and communication saved a precious resource

Miss Katie East1, Mrs Fiona Clarke2, Miss Penny Toland3, Mrs Quirine O’Loughlin3
1Gold Coast Hospital and Health Service, Southport, Australia, 2Cancer and Access Support Services CASS, Gold Coast Hospital and Health Service, Southport, Australia, 3Pathology Queensland, Gold Coast University Hospital and Health Service, Southport, Australia

Background: Blood is a precious resource that is provided by voluntary, non-remunerated, eligible donors across Australia.  It is the responsibility of end users within health services to ensure responsible utilisation of this precious resource.  National and Queensland Red Blood Cell (RBC) targets are established to minimise wastage. RBC wastage targets vary depending on the number of units issued to a health service. Notably, the RBC wastage was higher in the emergency and theatre departments when compared to other clinical areas.
Aim: Reduce the amount of blood product wastage, raise the profile of voluntary blood contributions, encourage a multidisciplinary approach and support emergency service workers to donate blood and blood products where eligible.
Methods: It was not until the nursing staff in ED and theatre accepted responsibility that outcomes were achieved.  The following initiatives were implemented:

  • A visual and auditory alarm system was added to the blood pneumatic tube system in ED
  • Paper forms were amended to improve cold chain documentation of RBC units
  • Increased education about maintaining cold chain compliance
  • Ongoing education to improve vigilance
  • A healthy competitive spirit between ED and Theatre to reduce waste
  • Blood bank staff were also invited to improve communication between departments
  • “Blood BBQ” education day in ED
  • Monthly updates on waste and tracking of how this occurred for each unit
  • The ARCBS attended to promote the Health Service Blood Challenge

Results: Post implementation data shows an improvement of average RBC wastage rate to now 1.5% (Jan-July 2017) which is lower than the state RBC wastage target of 2.0%. RBC units reduction in waste by 63%.  The teams have reduced the associated costs of RBC wastage from $24,924 to now $9,246.  A cultural change has been embedded in the emergency and theatre departments to improve RBC wastage.

Katie is an experienced clinical nurse working at Gold Coast University Hospital Emergency Department and a sessional academic at Griffith University and Southern Cross University.  Katie is a qualified rural and isolated practice nurse that is passionate about quality healthcare access in rural areas. As part of her emergency position she also works with the Queensland Police Service ensuring healthcare access to individuals held in police custody.   Katie is also a research coordinator with a keen interest in harm minimisation for risky behaviors involving alcohol and drug intoxication. Katie received an Australia Day certificate of achievement in 2014 for her excellence in healthcare for duties during cyclone Yasi.  Katie also received several learning and teaching excellence awards in 2017 for her ongoing work with undergraduate students in nursing.