Recently a donor shared feedback about some discomfort following a blood donation in one of the camps. Following the routine process, the donor was counselled, reassured and informed that the medical officer of the concerned blood bank will give him/her a call. The contact was passed on to the medical officer. We believed that the matter was taken care and as a routine process we would have called the donor a day or two later just to be sure that he is doing well. However, we were very surprised when the medical officer concerned called us back complaining that the individual had no problem what-so-ever and the call was un-necessary. We were pretty surprised. Before we went further, we rechecked how we got to know of the complication. At the end of each drive we give a card to the donor. We request them to save the contact information to be used in case they find anyone looking for blood or in case they need any assistance. The card is designed to be small enough to fit inside a purse, so that it is readily accessible. This individual had made use of the information on the card to send us an email detailing his problem. He was not complaining in his tone. Rather he had clearly indicated the discomfort he was facing (painful arm and bruise) and requested to know if he should do something about this on an e-mail. How could a person who had taken the time to write a detailed email about his condition inform the medical officer that nothing had happened?
It turned out that the person who had called to follow up with the donor was directing his/her questions to identify if there was any serious discomfort. When the donor communicated that he had only felt mild discomfort and just wanted to be sure if everything was okay, the calling person was at a loss of understanding as to why something so minor should be reported in the first place. The donor indicated that he had no complaints against the staff. This was interpreted as 'nothing happened' by the caller.
It is not the first time that such situation has come before us. At Sankalp the volunteers are required to encourage feedback. In the last few years we have focussed on ensuring that the post donation complications do not continue to go unnoticed. In order to achieve this, we ensure:
- donor has an easy way to reach us if needed - and this is actively communicated to the donor during the donation process itself
- if the donor contacts there should be a patient ear to listen to the donor, understand the factors contributing to the situation, estimate the extent of urgency for intervention, plan the intervention strategy and later follow-up to be sure that adequate intervention was given
- progressively identify patterns in situations of discomfort reported and identify strategies to mitigate them
The way Sankalp India Foundation looks at feedback including reports of discomfort from the donor is an additional opportunity to repair the potential damage to the motivation and well-being of a voluntary blood donor. Medical literature from across the world indicates that a small number of individuals may have discomfort post blood donation and there is sufficient evidence to suggest that people who have some kind of discomfort are less likely to donate blood again. We believe that intervention from the institutions involved in blood collection to reassure, comfort and even simply listen to the donor in the event of discomfort has a positive impact on the immediate well being and the chances of future donation. Even if it was to be completely disassociated with the return rate of donors, we believe that ensuring that blood donation leads to minimum discomfort of any kind is a worthwhile goal to pursue and a responsibility of the institutions involved in blood collection.
As our country develops and moves forward, we need to strengthen our error/adverse event prevention, detection and management capabilities. Blood banks need to move towards serious and well designed quality assurance schemes and translate their commitment to safety and quality in the form of action items and protocols. The pre-requisite of moving towards a safer, more reassuring and comfortable blood donation program is openness to feedback and honest root cause analysis. The investment that blood banking makes in this direction is not only a responsibility, but will also translate into donor loyalty and retention.
The way Sankalp India Foundation looks at feedback including reports of discomfort from the donor is an additional opportunity to repair the potential damage to the motivation and well-being of a voluntary blood donor. Let’s ensure that we are listening.