Performance analysis is very important as it fosters thought by encouraging us to look at areas of improvement. In 2015, Sankalp India Foundation published a write up in the Asian Journal of Transfusion Science (AJTS) on the non compliance of blood banks to agreed upon standards in blood donation drives. In 2016, we had the publication on adverse events and complication management in the same journal. The deeper intent of going through the exercise of compiling data for the publications was to devise a culture within the organisation to have internal analysis done at regular intervals. Be it thalassemia, BMT or our blood donation drives, we believe that from time to time we must analyze our results and take corrective actions.
There is no well documented definition of how to rate blood donation drives for quality. We have been dwelling upon this question for quite some time. Time and again we try to look at the blood donation drives from a variety of perspectives. What is done here is another such attempt. We looked at the following factors to understand if performance by teams in blood donation drives is influenced by the already available stock in blood banks:
- non compliance to quality standards,
- rate of adverse complications,
- rate of deferrals
- the overall camps and collection.
The seasonal variation of blood in Karnataka is now a well established fact. While April to July and December to January can be considered as challenging months to sustain good stocks in blood banks, the period between August to November and February to March are much easier (At times there is also a heavy red cell overload in these months). We took this as an important element to be considered while we sit to measure the performance.
An analysis of 336 blood donation drives organised by Sankalp India Foundation in the period between 1 January 2015 to 31 January 2017 in Karnataka (more than 95% of which was in Bangalore) was made to study the perceivable quality of blood donation drives throughout the year (with focus on the seasonal windows).
Unfortunately, the data shows that the quality offered to donors in blood donation drive varies according to available stocks.
A brief interpretation of the results can be made as follows:
- The rate of adverse complications remain nearly the same This does not seem to have got affected with shortage.
- The rate of deferrals is distinctly different in periods of high stock and low stock. During periods of good stock, nearly 3.5% more donors are deferred clearly throwing questions to ask if the deferrals were actually scientific.
- The rate of non-compliance per blood donation drive is significantly higher in the time of year when there are good stocks. The percentage of blood donation drives having at-least one instance of non compliance is also higher in periods of good stock. This suggests that blood bank teams are choosing to be compliant to standards only when there is a pressure to get more units from voluntary blood donors.
Our findings suggest that more works remains to be done in the direction of ensuring that each voluntary blood donor is given the same quality of care all the time. Each donor must be given a fair and scientifically guided opportunity to donate. Each camp must be done with attempts to achieve highest standard of quality and safety. Both these parameters seem to be getting significantly affected by the demand supply equations and there is an urgent need to fix this.