Blood Transfusion Service, Massachusetts General Hospital, Boston, Massachusetts, USA.
Transfusion. 2021 Mar;61(3):722-729. doi: 10.1111/trf.16299. Epub 2021 Feb 12.
Spikes in the demand for blood components represent a substantial challenge to transfusion services. Simple metrics for characterizing volatility in blood components within the hospital transfusion service have not been established.
We measured the volatility of demand for blood services at a large academic urban general hospital over a 6-month period from July 2019 to December 2019 prior to the SARS-CoV2 pandemic.
Among 4416 consecutive hours assessed, there were 693 h (16%) with spikes in demand for blood components with a mean (sd) of 3.8 (2.7) spikes/day. Spikes in demand were frequently clustered. The median number of hours between spikes differed by shift (6 h for days; 3 h for evenings; 3 h for nights). The percentage of shift hours with demand spikes also differed (9% day; 19% evening; 18% night). During the study, 32,447 components were distributed to 19,431 patients. Of these, 11,819 components (36%) were distributed during hours of peak demand. Hours with a simultaneous spike in both component demand and patient demand occurred in 5% of hours or approximately once each day.
Demand for transfusion services was highly volatile in an unpredictable fashion. We provide an approach that could be used to benchmark spikes in demand for blood services at hospitals. Consideration of the frequency, unpredictability, and magnitude of spikes in demand may be relevant for hemovigilance programs and for strategies to determine the laboratory staffing needed for good patient care.
血液成分需求的激增对输血服务构成了重大挑战。目前尚未建立用于描述医院输血服务中血液成分波动的简单指标。
我们在 2019 年 7 月至 12 月 SARS-CoV2 大流行之前的 6 个月内，测量了一家大型学术性城市综合医院的血液服务需求波动情况。
在评估的 4416 个连续小时中，有 693 个小时（16%）出现了血液成分需求的激增，平均（标准差）每天有 3.8（2.7）个峰值。需求激增经常聚集在一起。两次激增之间的中位数小时数因班次而异（白天 6 小时；晚上 3 小时；夜间 3 小时）。需求激增的班次百分比也不同（白天 9%；晚上 19%；夜间 18%）。在研究期间，向 19431 名患者分发了 32447 个组件。其中，11819 个组件（36%）是在需求高峰期分发的。组件需求和患者需求同时激增的小时数占总小时数的 5%，即每天大约发生一次。
输血服务的需求呈不可预测的高度波动。我们提供了一种可用于基准医院血液服务需求激增的方法。考虑需求激增的频率、不可预测性和幅度可能与血液警戒计划以及确定良好患者护理所需的实验室人员配置策略相关。
