The Transfusion Medicine Laboratory (TML) at St Paul’s Hospital (SPH) is the recipient of the 2020-2021 BC Provincial Blood Coordinating Office (PBCO) Utilization Management Award.
This designation was achieved for outstanding participation as the receiving site for redistributed factor products in the province. The provincial Factor Product Redistribution Program (FPRP), in the last three years alone, has resulted in a cost savings in excess of $2 million dollars.
Factor products are costly and most TMLs throughout BC and Yukon (BC&Y) carry these products for the prevention or treatment of bleeding episodes in patients with factor deficiencies, von Willebrand Disease, and inherited bleeding disorders.
The shelf life of coagulation products is about two years and as demand can sometimes be difficult to predict, product sometimes runs the risk of expiring.
In 2006, the PBCO started the Fractionated Product Conservation Program (FPCP), with the objective of eliminating the expiry of factor products at hospitals throughout BC. In early 2010, the program was further expanded to include other coagulation blood products, now called the Factor Product Redistribution Program (FPRP).
Under the FPRP, all BC&Y hospitals are asked to send near expired products (less than six months) to the primary redistribution center, SPH TML in Vancouver, or a larger center within their health authority for reallocation. The TMLs, work with the BC Pediatric and Adult Bleeding Disorder Programs to ensure that the short-dated product is utilized prior to expiry.
To facilitate this process, Nurse Practitioners at both programs monitor a SPH shared data base which identifies the amounts and locations of short-dated products ready for redistribution.
All patients cared for by the programs are enrolled in the Inherited Coagulopathy and Hemoglobinopathy Information Portal (iCHIP), which is a data management tool for patients to track their use of home factor products and bleeding records. iCHIP links to a clinical module which, among other functions, enables the clinicians at each program to view the quantity of factor the patients have remaining at home.
There is a significant amount of time, coordination, and communication required between all parties to ensure the appropriate amount of factor is redistributed for patients to utilize before the products expire.
The success of the FPRP comes from the stewardship and hard work of Tina Jacobucci, Team Lead, SPH TML, Colleen Chan, Tech Coordinator, SPH TML, Michelle Bech MN ACNP NP (A), Karen Sims MN ACNP NP (A), Erica Crilly NP (P), Celina Woo NP (P), the TML technologists throughout BC&Y hospitals, and the homecare patients who utilize these products.
The programs would like to acknowledge the time and flexibility of persons with bleeding disorders who play a pivotal role in the redistribution process, as they accept different vial sizes that may require pooling – which can sometimes make their daily home factor infusions more challenging.
It is gratifying to see that as a result of our ongoing collaborative time and efforts we have achieved a significant cost savings to BC’s healthcare resources.
St Paul’s Hospital Transfusion Medicine Lab
Tina Jacobucci, Team Lead and Colleen Chan, Tech Coordinator
Adult Bleeding Disorder Program of BC/Yukon, St Paul’s Hospital site
Nurse Practitioners: Michelle Bech MN ACNP NP (A) and Karen Sims MN ACNP NP (A)
Pediatric Bleeding Disorder Program of BC/Yukon, BC Children’s Hospital site
Nurse Practitioners: Erica Crilly NP (P) and Celina Woo NP (P)