Page 85 - Hospital Authority Convention 2017

Service Enhancement Presentations

F8.2 Young HA Investigators Presentations 14:30 Room 421

A Cluster-based Inventory Management Programme Leading to North District Hospital Blood Bank Service
Enhancement on Platelet Transfusion
1
2
1,2
2
Ip RKL , Lui YK , Fung KFP , Wan SK , Ng MHL 1,3 HOSPITAL AUTHORITY CONVENTION 2017
2
1 Blood Bank, Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, Blood Bank, Department of
3
Pathology, North District Hospital, Division of Haematology, Department of Anotomical and Cellular Pathology, The Chinese
University of Hong Kong, Hong Kong
Introduction
The corporate-wide average platelet wastage is around 2-3%. For a long time, there is an exceedingly high platelet wastage
of >30% (> 600 units per year) in North District Hospital (NDH), which also has a restricted platelet stock.
Review of transfusion data identifies that there is a vicious cycle that platelets are over-reserved and for relatively non-
indicated patients (e.g. platelet count >100x109/L) for fear of lacking platelet supply when needed. With a short self-life
of platelets (five days), reservation for just-in-case transfusion further reduces the availability of platelets stock and also
contributes to high platelet wastage, deferring negotiation for increase in platelet stock from HKRCBTS as monitored by
Central Committee (Transfusion service).
Objectives
(1) To reduce platelet wastage in NDH; (2) to maintain a stable platelet stock in terms of quantity and functional life with timely
supply; (3) to break the above vicious cycle by addressing the worries of clinical teams and hence promote a better working
partnership from bench to bedside

Methodology
A cluster-based inventory management system and logistics are developed and implemented through dynamic monitoring of
platelets stock with temperature monitored re-direction and circulation of platelet units within New Territories East Cluster.

Phase one:
Since March 2015, we have successfully negotiated with Prince of Wales Hospital (PWH) for taking up nearly expired (Day
four/five) platelets when they are not used up by routine cluster transport on weekdays, and by taxi on weekends and public
holiday. To facilitate urgent platelet transfusion when platelet stock is not available in NDH, PWH has also backed up the
platelet stock support by a direct one-way delivery (PWH to NDH) instead of two-way delivery (NDH to PWH to NDH).
Phase two:
Further to these stock logistic initiatives and drastic improvement in platelet wastage, we have successfully liaised with
HKRCBTS again to double the regular platelet stock in NDH to a higher level of eight units since November 2015.

Results
By a cluster-based service, PWH Blood Bank has served as a secondary parent stock and also absorbed the wastage
generated by NDH through dynamic stock monitoring and higher utilisation rate. No raise in platelet wastage is observed in
PWH (2%).
Phase one programme has dramatically reduced the platelet wastage in NDH from >30% (>600 units per year) to 7% (116
units) in 2015. Wednesday, 17 May

Phase two programme ensures a very stable stock in NDH with reduction of monthly extra platelet transportation from PWH
or HKRCBTS from 15 to 7 times on average. This timely supply also addresses the worries of clinical teams with alleviation of
tension amongst clinical and laboratory frontlines. Less just-in-case reservation is recorded. A further reduction of platelets
wastage to 4% (58 units) is observed from January to November 2016.

This pilot programme illustrates that a win-win outcome is possible on both resources utilisation and service provision
through a cluster-based inventory management system.

229