Summers are always tough for blood centers, but it looks like this one will be worse than usual. Multiple hits on the donor base (enumerated in last week's Newsletter) have converged in what one center CEO called a "black swan" and "perfect storm" in the SAME sentence. We will respond by rounding up the "usual suspects" to get through until Labor Day: public appeals, appeals to established and lapsed donors, special blood drives, badgering our hospitals about judicious transfusion, rotating inventory to sites of greatest need, importing when possibleet al. All that said, a big slice of the problem is that we run our business like my father ran his butcher shop in the 1950s. Izzy got his beef from the wholesaler "just in time," and consequently the ground beef in the display case was always bright red-nothing was old enough to turn brown-so nothing had to be pitched (i.e., outdated in our argot). Problem was that if a big customer needed a couple hundred pounds on Friday for a party on Saturday, the inventory was short. We in the blood community, as a business strategy to protect margins, have abandoned the inventory cushion that is critical for responding to sudden need. What was reasonable in an Iowa meat market in 1950 has troublesome implications for a blood system.
Can this be fixed? Hard to say, and will likely demand fundamental changes in our business/system model. Let me give you a short update on an initiative to answer the question. In January 2014, ABC began talking about an independent study to measure the "value of blood" in the context of the evolving healthcare system, but in short order, we realized we could not foot the bill. With financial support from the Department of Health and Human Services (HHS), and input from multiple stakeholder/experts on a subcommittee of the Advisory Committee on Blood and Tissue Safety and Availability (ACBTSA), the RAND Corporation was (competitively) contracted to execute an analysis of the current state of the blood system and to make policy recommendations to ensure its sustainability. The report will include a number of subject matter modules, several of which have begun peer review at RAND and several more of which are close to that milestone. ABC believes that the final report, which will be reviewed before release at HHS, by the subcommittee, and the full ACBTSA, will be available in late fall. I wonder if next summer will look any different.
P.S: The old man got smart and switched to making neon signs.
Louis Katz, MD; Chief Medical Officer; firstname.lastname@example.org