PHP259 - Tasks Involved In Platelet Production And Transfusion From The U.S. Hospital Perspective: Two Process Frameworks

Abstract

Platelet production (PP) and transfusion are complex processes, largely due to pathogen testing. Pathogen reduction (PR) is a new technology that has the potential to improve PP efficiency by simplifying these processes. Objectives of this project were to 1) develop frameworks detailing tasks involved in each process: one from the hospital blood donor center (BDC) perspective describing PP tasks, and the other from the hospital transfusion service (TS) detailing tasks for platelet procuring and administration (PA); and 2) assess the impact of PR on these processes. Identification of tasks involved in producing and procuring conventional (non-PR) platelets was informed through literature review and discussion with clinical experts. Major tasks were identified in both processes, along with possible branching of pathways within each process. The frequency of tasks was assessed for conventional vs. PR PP, with categorization by type to identify which task groupings were major contributors to the complexity of the process. Major PP tasks include apheresis donation, processing, bacterial culturing, infectious disease testing, storage, shipping to hospital, and returns. PP comprises 14 tasks with conventional platelets vs. 12 tasks with PR platelets. Major PA tasks include receipt of shipment, storage, point-of-issue (POI) bacterial testing, physician ordering, administration to patient, and adverse event (AE) management. PA comprises 15 tasks with conventional platelets vs. 13 tasks with PR platelets. POI is task-intensive, requiring up to 6 additional steps per test repeated every 24 hours, ranging from 2-6 tests/platelet unit depending on platelet age. Noninfectious AE tasks are similar for both conventional vs PR however infectious AE are expected to be reduced or eliminated with PR. The PP frameworks can be used in hospital operations research to simplify and improve PP efficiency. PR platelets represent a means of reducing tasks, and potentially costs, of producing and administering platelets.