A Prescription for Erythrogizer

Red blood cells (RBCs) may well be the Rodney Dangerfield of pharmaceuticals because they seem to get no respect. In fact, two major thrusts in transfusion medicine, patient blood management, and hemovigilance, tend to accentuate negative aspects of transfusion care with inherent messages that blood is very risky and needs to be either avoided altogether or, if given, closely scrutinized. Seldom is heard the encouraging insiders’ word that RBCs are a miracle drug, which in various situations can save your life, provide you comfort, give you energy, sharpen your thinking, and even improve your appearance. Unfortunately, given the current cost-saving pressures in healthcare, such undervaluation may be causing episodes of under-transfusion that adversely affect quality of life for patients and their caregivers. Read Full Post >


Advocating for Advocacy

Advocacy is one of ABC’s central priorities – we know that it is one of the most highly valued services of ABC’s activities. We have excellent but limited resources, so we must be focused. At ABC’s board retreat this week, we determined four priorities to address this year, chosen based on the SEQuaLS member satisfaction survey results and the likelihood of success. Read Full Post >


Whither Zika Virus?

ABC posted talking points about Zika virus to the Member Website last week. That was in the context of this Flavivirus spreading from its “home” in Africa eastward, with extensive epidemics in South and Central America and the Caribbean Islands (see Fauci AS, Morens DM). Driving immediate concern is a temporal and geographic association of Zika activity with the increased incidence of a devastating neurodevelopmental abnormality, microcephaly, especially in Brazil. The hypothesis is that in utero Zika infection is responsible. CDC has issued a warning for pregnant U.S. women going to affected countries (see CDC’s Interim Guidance). Read Full Post >


Recovered Plasma and New MSM Deferral Guidelines

The Food and Drug Administration’s (FDA) long awaited final guidance “Revised Recommendations for Reducing the Risk of Human Immunodeficiency Virus Transmission by Blood and Blood Products” was is-sued in December. The permanent deferral of men who have a history of sex with other men since 1977 (MSM) has been eliminated and otherwise qualified donors with a history of MSM who have had no such sexual contact in the last 12 months are eligible to donate blood. What may appear to be a straightforward decision to implement revised donation procedures to accommodate the guidance is complicated by recovered plasma (RP). Read Full Post >


We Love You, We Love Our Mission, We Want You to Become Part of Us

Sound familiar? For most organizations contemplating partnership opportunities, mergers, or acquisitions, this sentiment serves as a foundation for considering opportunities with a trusted partner. Read Full Post >


As The Year Draws Nigh

As the end of 2015 draws nigh, I decided to clean house and accomplish my “ABC 2015 To-Do List” to clear the way for 2016 New Year’s resolutions. I am sharing this list with you today in the hopes that you will find it in your heart to review these items and pitch in to lay the groundwork for an even better, stronger ABC. Read Full Post >


Just When You Thought it Was Safe to go Back in the Water

It is time once again for the Department of Health and Human Services’ (HHS) National Blood Collection and Utilization Survey (NBCUS), conducted by the Centers for Disease Control and Prevention (CDC). I know it seems like only yesterday (actually last winter) that you participated, but the latest data available on these things is from 2013. Preliminary results of the 2013 NBCUS were presented at this year’s AABB Annual Meeting in Anaheim, Calif., and CDC will aim to publish the results by early 2016. The survey results are used to generate national estimates of blood collections and transfusions to understand current blood use and to project future blood needs. Amongst the Feds, the data accumulated is of particular use to the Centers for Medicare and Medicaid Services, the Food and Drug Administration, the Health Resources and Services Ad-ministration, and the National Institutes of Health – in addition to HHS/CDC. For the blood community, the data are critical in our advocacy efforts. Read Full Post >


Thoughts on This Season

This traditional holiday season of peace, love, and joy has been shattered by senseless acts of in-comprehensible violence. The mass shootings last week in Colorado Springs, Colo. and San Bernardino, Calif., as well as the earlier horror in Paris, Mali, Turkey and others remind us of the dark side of the human experience. Such aberrant behavior is so repugnant as to defy description. Yet with each horrible event, the positive side of human behavior comes forward. As one of our blood center colleagues Joe Chaffin, MD, at LifeStream in San Bernardino, located a mere half-mile from the scene of the shooting, recently wrote in a communication to ABC members: Read Full Post >


Expecting the Unexpected

Last week, the Advisory Committee on Blood and Tissue Safety and Availability (ACBTSA), which reports to the Undersecretary for Health of the Department of Health and Human Services, met to discuss the sustainability of the U.S. blood supply. Among the concerns was the worry that a shrinking blood inventory and collection system, appropriate to the reduced level of routine red cell blood use, would not be able to provide appropriate surge capacity. Read Full Post >


Veterans Paved the Way for Our Modern Blood Banks

On today of all days, as I write this column on Veteran’s Day, I am reminded of the enormous im-pact our veterans have made on this country. They put their lives on the line so that we may enjoy our freedoms and way of life. As members of the blood banking community we also realize that veterans paved the way for modern transfusion technologies. During World Wars I and II the critical need for blood on the battlefield progressed transfusion techniques and allowed for the organization of the blood banks we know today. Read Full Post >


What are the Realities to Consider as We Think About Implementing Pathogen Reduction of Platelets in the U.S.? (1)

The transfusion medicine community welcomes approval of Cerus’s Intercept Blood System for pathogen-reduced (PR) platelets. It is an important safety step that will nearly eliminate bacterial contamination episodes, and be particularly valuable if paired with decreased testing, increased shelf-time, and the elimination of product irradiation. It is a first step to future PR systems that will be easier to use. Read Full Post >


Where We’ve Been and Where We’re Going – The ABC Professional Institute

It is amazing how quickly a calendar year flies by. Here we are almost at the end of October and preparations for the holidays and end of the year have already begun. It is also hard to believe that just a year ago at this time is when we started planning the first stages of the ABC Professional Institute (API) – a one-stop-shop for all of ABC’s educational offerings. Reflecting on that first year of bringing the API from a concept to a tangible item, it is exciting to look back on what has been accomplished: Read Full Post >


One Week: Two Communities, Two Tragedies

It is often said that families are “connected by blood.” Communities are too. On Sept. 24, a Ride the Ducks tour vehicle in Seattle collided with a charter bus going over the Aurora Bridge carrying students, resulting in five fatalities, 11 patients with serious injuries, and more than 20 others admitted to eight area hospitals. One week later, 350 miles away, shootings at Umpqua Community College in Roseburg, Ore. resulted in 10 deaths, with nine others hospitalized in critical condition. Read Full Post >



I can’t believe it has been over 13 years since I joined this wonderful association. What started as a temporary “stint” subbing for a membership manager who was going to be on maternity leave, blossomed into a fulfilling career, filled with professional growth and opportunities to learn and work with talented colleagues, and committed members and blood banking professionals in the U.S. and abroad. Read Full Post >


Let’s Put Our Money Where Our Mouths Are

A persistently important issue mentioned when ABC staff discusses advocacy with the members has been the quality control (QC) burden associated with labeling and distributing leukoreduced (LR) apheresis platelets. FDA has determined that we must demonstrate statistically, with validation and QC testing, that our processes attain and maintain 95 percent confidence that 95 percent of our units contain <5 x 106 residual white blood cells (WBCs). This level of performance is clinically appropriate in my clinician’s brain (spare me the epithets please). If we believe that LR is clinically important, we should be stringent about what we distribute. The problem comes when the QC burden is greater than the QC benefit. Many of us think that with our robust plateletpheresis platforms and processes, we are well past that threshold. Read Full Post >


Bringing Transfusion Practice into the 21st Century

Last year, America’s Blood Centers created the Transfusion Safety Committee as a subcommittee of ABC’s Scientific, Medical, and Technical (SMT) Committee. Our charge is to organize and promote the integration of ABC centers with their customers through transfusion safety officer (TSO) services, including patient edu-cation, clinical staff education, and patient blood management. We developed a transfusion safety project list via a survey of the ABC Transfusion Safety Forum members. Read Full Post >


Spreading the Word

Last week marked the end of a successful America’s Blood Centers-led grassroots campaign, culminating in the submission of two comment letters from ABC within a one week period and a face-to-face meeting with the Centers for Medicare & Medicaid Services (CMS) and the blood community delegation. During the past seven days, ABC has commented to CMS in opposition to the proposed cuts in reimbursement for blood and blood products, as well as to the Department of Labor expressing concern about the impact of the proposed increase in the threshold for exempt status and payment of overtime on non-profit organizations like blood centers. Read Full Post >


For Some Years, I Have Been Afflicted with the Belief that Flight is Possible to Man – Wilbur Wright

My grandparents had beach cottages at Nags Head, on the Outer Banks of North Carolina. We went there almost every summer while I was growing up. Mostly, I remember playing in the surf and watching the adults play long, spirited games of Monopoly. There was always a trip up the beach to Kill Devil Hills where the obelisk of the Wright Brothers Memorial sits atop a small dune, and to the museum with tools and models of their early planes, which they tested in the winds off the ocean. Read Full Post >


Innovation Over Faster Horses and Great White Whales

Economic pressures within the healthcare industry and, specifically the blood enterprise, have exposed a red ocean of competition replete with sharks attacking for the lowest price, mercenaries invading territories to acquire new market share, and a landscape ringed by beachheads strategically positioned to stave off conquest for a shrinking transaction base. Mergers and acquisitions in the supply chain and customer base have yielded market consolidation and blood has become commoditized as hospital administrators squeeze every cent from the supply chain. Long gone is the laissez-faire magnanimity, once the hallmark of the blood banker, replaced instead by fierce competition for the lowest possible price with the fervor of Captain Ahab’s quest for the Moby Dick. Read Full Post >


Patient Blood Management: Some Comments from Others and Some From Us

“The Ethics of Bloodless Medicine,” published Aug. 14, was the last in a trilogy of articles in The New Yorker discussing lessons learned from transfusing, and not transfusing Jehovah’s Witnesses. The reports are in keeping with the magazine’s habit of regularly addressing medical topics (see also “The Excrement Experiment, How a stranger’s feces might save your life,” Nov. 24, 2014 and “Can AIDS be Cured? Researchers get close to outwitting a killer,” Dec. 15, 2014). Read Full Post >


When ‘Sorta You’ Isn’t You (or Why we Need the Data Warehouse)

Many of you may have seen the recent Esurance commercials with the theme “sorta you, isn’t you.” In one, Giants catcher Buster Posey runs into a maternity room ready to deliver a baby stating that he is “sorta like a doctor because he wears a glove and delivers in the clutch.” Needless to say, the expectant father so infatuated with Buster that he considers allowing him to deliver, but the expectant mother wants her physician, not someone “sorta like” her physician, to actually do the delivery. Read Full Post >


Are we Suicidal or … ?

I’m corresponding with a healthcare economist (that can’t be good) about framing the medical, insurance, and public health value of blood in light of historic and future safety and regulatory imperatives. The goal is to describe our business and how to make it sustainable. When Centers for Medicare and Medicaid Services (CMS) proposed cuts (≈30 percent on average) to outpatient reimbursement for blood were published in the Federal Register, adding to our fiscal miseries, my old pal asked: “Why is the market for human blood not creating the efficiencies among the suppliers that the demanders want, yet leaving them a normal [sic] profit?” Read Full Post >


Check Out ABC’s New Member Site

With the summer months upon us, and what may be considered a slightly slower pace, many of us use these quieter times around the office to catch up on tasks we’ve been putting off. While it can bring such simple satisfaction to cross items such as “clean out inbox” and “dust keyboard” from your to-do list, it is also the perfect time to take part in professional development. And, what better way to do so than by checking out America’s Blood Centers’ new Member Site launched just last month? Read Full Post >


Organizational Resistance and Resilience

Change seems to be everywhere in the blood community these days – evolving business relationships, new technologies such as pathogen reduction, and emerging transfusion-transmitted biological agents such as Babesia. The ever-changing regulatory landscape is another key element in our environment that can create commotion in the blood industry. Read Full Post >


Genetic Testing – What Does it Mean to us?

Blood centers are probably the largest providers of “genetic testing” for adults in the country. Of course, we do serological ABO and RhD typing on every sample. We can also test for many other antigen systems. Until recently this was a common way of doing paternity testing. We are doing ever more red cell genotyping and using these results to provide better patient care for patients with multiple antibodies, enriching our inventory of rare units. We screen for sickle cell trait in a substantial number of cases by both chemical and molecular methods. We are in the genetics world, whether we think of ourselves in that way or not. Read Full Post >


The Red, White, and Blue

Saturday is the Fourth of July – a day when we celebrate our country and our freedom. So it’s a particularly appropriate time to consider the relationship between the blood world and our government. (Okay, the decla-ration of independence was signed on July 4, establishing the anti-government; the government we have now was not really established until several years and a failed try later. But we will celebrate this government anyway.) Read Full Post >


Just Say No?

Donors often visit places where infections not (yet?) endemic in the US are spreading. Dengue and chikungunya viruses are the current hotties, with Zika and Ross River viruses coming on strong. Each of these viruses, like West Nile virus, is characterized by asymptomatic viremia – the virus circulating in the blood before any illness – for several days, which may pose a transfusion risk. Potential exposures to malaria exclude many such donors, but nowhere near all of them. A short deferral of 14-28 days after return from international travel will get these donors past the risk. Can we do it? Asked more directly, how would such a deferral affect the blood supply? Read Full Post >


An Organization Without Data is Doomed to Follow, Never Lead

This past week, I launched two important surveys on behalf of America’s Blood Centers to our members. Despite having retired from ABC in April, I agreed to conduct them again, because I have done them for several years and have learned from our members the importance of the final reports. The data from these two reports – the Executive Compensation Survey and the Financial Ratio Survey – have generated more discussion and are more useful to ABC members than most of the other surveys that I have facilitated. Read Full Post >


What is a “Member” and Why Does it Matter?

It seems like a simple question with a simple answer, but in the past year, America’s Blood Centers has been struggling to answer it. First, a member is a dues-paying entity. There are currently 65 members in the net-work (down from 78 when I joined ABC in 2002). For the official definition, we turn to the ABC Bylaws, in which an active member is defined as a US or Canadian government-licensed, non-profit community or re-gional blood program governed by an independent board of directors serving two or more hospitals. In reali-ty, however, members come in a variety of shapes and forms. The current healthcare environment, which has placed blood centers under strenuous financial pressure, has led to the adoption of both traditional and inno-vative business models that have reshaped ABC membership. Today, 76 percent of members fit the definition above. However, the remaining 24 percent are either independently licensed affiliates, units or divisions of other members (14 percent), holding companies (five percent), or “other” (academic, hospital-based, or non-US). Nothing prevents that 14 percent from being folded into their parent company’s membership, receiving the same membership benefits (minus the right to vote). Read Full Post >


Always Be Prepared

Spring has arrived, but unfortunately, with it comes tornado season brought on by the collision of warm air of the South and the colder air still creeping down from the North. As we’ve already seen in Oklahoma, spring tornadoes can be devastating. Memorial Day signaled the “unofficial” start of summer and just this week was the official start of hurricane season. This is always an opportune time to review local disaster/emergency operations plans. These should be reviewed at least annually, if not more frequently, with a critical eye. Below are some key questions to keep in mind when reviewing your plans. Read Full Post >


Standing on the Shoulders of Giants

Isaac Newton once wrote to rival Robert Hooke in 1676, “If I have seen further it is by standing on the shoulders of giants.” Many years ago, when I was a young “wet behind the ears” medical director of a small blood center in the middle of nowhere, I received a phone call that changed my professional life. Celso Bianco, MD, then-president of ABC, shocked me by calling to graciously invite me to serve as co-chair of ABC’s Scientific, Medical, and Technical (SMT) Committee, along with Lou Katz, MD. As a relative newbie from a small blood center, I felt inadequate in the face of such a challenge, but Celso assured me I would be provided lots of assistance. After consulting my CEO at the time, John Guthrie, I accepted Celso’s offer. I both survived and enjoyed my stint as SMT chair, going on to serve on other committees at both ABC and AABB. I tell this story partly to thank Celso and Lou, both of whom have become personal friends over the years, but also to highlight their generosity and graciousness in confidently handing the torch to the next generation. Read Full Post >


Why FDA Should Refer Babesia Policy Discussion to the ACBTSA

The Food and Drug Administration’s Blood Products Advisory Committee (BPAC), rejecting recommenda-tions from the blood community, endorsed nationwide serological testing for Babesia microti, combined with nucleic acid testing (NAT) of donations collected in high-risk states (see ABC, AABB statements). This means testing millions of donors with virtually no infection risk, consuming limited resources that might be better used elsewhere in pursuit of patient safety. The model presented to BPAC by the agency on the impact of testing is based on unvalidated diagnoses of babesiosis derived from Centers for Medicare & Medicaid Services (CMS) claims data in a population (elderly Medicare beneficiaries) that does not reflect donors (see BPAC issue summary). This is in contrast to direct evidence from prospective Babesia screening by the American Red Cross, suggesting that much more limited testing is just as protective as extended screening and more cost effective. Read Full Post >


Pathogen Reduction: What’s Changed in the Last Two Years?

When I last commented on pathogen reduction (PR) in an “Our Space” two years ago, there was a sense of hope that PR was at our doorstep. Cerus had just received the greenlight from FDA to submit Premarket Ap-proval applications for its Intercept system for platelets and for plasma, which gained licensure in 2014. Now, Terumo BCT has submitted an Investigational Device Exemption (IDE) to begin its MiPLATE study for the Mirasol PRT system for platelets, which is expected to lead to licensure of the system. Terumo BCT is also developing a PR platform for whole blood. Data from the company’s IMPROVE II feasibility study, focused on radiolabel recovery of red blood cells after 21 day storage from PR-treated whole blood, has been submit-ted as an abstract for the 2015 AABB meeting in Anaheim, Calif. Read Full Post >


The Value of Continuing Education

Shortly after completing my graduate education, I pondered how I would gain knowledge in the future, assuming it would come from my routine work activities. Surely just “doing my job” would keep me updated on issues affecting my environment and prepare me to meet challenges and accomplish goals. Well, not quite. Entering a tightly regulated industry that is highly reliant on technology and the ability to touch peoples’ hearts and minds left much to learn that could not be provided by on-the-job training alone. I am grateful that ABC invests in staff education and development to familiarize me with blood banking and association management – at the core of what we do. Read Full Post >


Technology: Use It Right

I once came across a quote online that read, “The whole idea is not about the choice between using or not using technology. The challenge is to use it right.” While that quote was unattributed, I could not agree more with whoever said it. Read Full Post >


Anemia Management and the Perioperative Surgical Home

While moving towards a value-based payment system has been disruptive to the healthcare industry, the benefits of these changes are now apparent in reduced patient complications and mortality due to a stronger focus on patient-centric care. As experts in transfusion medicine, we are vital to the patient care experience and it is essential to understand that improving patient outcomes is a top priority for our hospital partners. Through understanding the reimbursement process, blood centers can work alongside hospitals and physicians to share in the benefits of improved patient outcomes. This strategy is critical for blood centers to move our discussions away from blood product costs and to truly align ourselves as partners with the healthcare systems in our communities. Read Full Post >


A Walk in the Park

A study published in JAMA Internal Medicine suggested we may have been fooling ourselves a bit about the value of moderate exercise. Among Australians who exercised at all, the ratio of vigorous to moderate activity was an important predictor of mortality. This was true regardless of the total amount of exercise. Vigorous activity was defined as activity “that made you breathe harder or puff and pant,” like jogging, cycling, aerobics, or competitive tennis (“Social” tennis and gentle swimming were examples of moderate activity.) Controlling for various demographic, dietary, and physical factors, the amount of overall activity was important in reducing mortality. That is no surprise. Read Full Post >


How a Meeting Turned into an Event

Every March the ABC office is pulsing with energy. From early morning into the late evening, lots of synchronized teamwork takes place with every staff member playing a critical role, all to ensure the Annual Meeting runs without a hitch. This year was especially noteworthy; with several new features and announcements, we placed our focus on turning the meeting into an exceptional event. Read Full Post >


Involvement = Opportunity = Success

I never would have thought that 47 years ago, when interning for a local Certified Public Accounting (CPA) firm that performed the annual audit for the Community Blood Center of Greater Kansas City, that I would end up with a 40-plus-year career in blood banking. This will be my last opportunity to write an article for Our Space as an ABC staff member, so I thought I would use this opportunity to reminisce and share with you how ABC (formerly the Council of Community Blood Centers) has been a major part of my career. Read Full Post >


ABC Talks About Bugs in Platelets

Last fall, I said that a Food and Drug Administration Guidance on detection of bacteria in platelets was expected, and we got a draft in December. ABC’s Scientific, Medical, and Technical (SMT) group has spent the interval assembling comments on the guidance to submit to FDA. There is a strong sense that FDA’s approach in the draft is complex enough that the incentive of possibly extending platelet dating is inadequate to promote the critical intervention for sepsis mitigation, i.e. voluntary secondary bacterial testing with rapid assays or culture-based methods. ABC is asking that FDA reconsider and mandate the use of secondary testing in the transfusion service. Moreover, we propose simpler alternative strategies that would improve patient safety and allow extended platelet dating. For example, delaying primary culture until later in storage combined with the use of larger inocula in our culture systems will reduce the risk of bacterial contamination, while extending platelet storage to seven days without secondary testing. Such approaches are not perfect, but represent progress and would balance operational burdens and consumption of resources with a more flexible inventory. Going forward, we would be responsible for conducting surveillance to assess their impact and amending our approaches, when appropriate, based on the data. Read Full Post >


What We’ve Done For You Lately

Hopefully you attended Wednesday’s webinar on the recommendations of the ABC Dues Task Force and heard directly from ABC CEO Christine Zambricki about how ABC is working to accomplish our strategic goals. In the next couple of weeks, all ABC member CEOs and member voting representatives will receive their 2014 Member Value Report. I encourage you to review it and share it with your blood center colleagues. Read Full Post >


What About Fill Rate?

Effective patient blood management (PBM) is clearly an important principle in blood banking and, as part of any reasonable PBM approach, ensuring that we minimize waste is crucial to maintain credibility with our donors and control costs for our hospital customers. But blood product waste management does not equal PBM, and single-focused efforts on waste management could produce unintended (and unacceptable) consequences. In addition to the clinical aspects of PBM, I firmly believe any waste management initiative should have product “fill rate” as a crucial measure of success. If we do not include such a basic measure of performance in our studies and management strategies, we run the risk of cutting waste at the cost of reduced product availability. But how do we measure fill rate? How do we define it? Read Full Post >


Checking Our Iron Will

“Just let me check your iron,” the nice phlebotomist says to the prospective blood donor as she reaches to do the fingerstick. If only!! We do not in fact check anyone’s iron level; we check hemoglobin. While iron is necessary to produce hemoglobin, there is no direct relationship between the two. Even donors meeting our hemoglobin standard will, especially with repeated donation, have reduced iron stores. Low iron stores have been associated with fatigue, mental changes, and decreased exercise capacity. Last week, the Newsletter highlighted the Hemoglobin and Iron Recovery Study (HEIRS), which provided direct evidence that giving donors iron pills can reduce the time until hemoglobin level and iron stores are replaced. Should blood centers act on this and give our donors iron? Read Full Post >


No Experience Required

Are you the type of person who makes a to-do list? If so, I hope that the No. 1 item is your Capitol Hill visit on Tuesday, March 24, in conjunction with the ABC Annual Meeting. If you are like me, your to-do list needs specific boxes to check off. Here at ABC, we’ve taken the guess work out of your planning. Start early and you will be ready for this premier grassroots advocacy opportunity. Believe me, your members of Congress (MOC) will be delighted to meet with you, their constituent. Read Full Post >


Pathogen Reduction & Platelets: Are We Inflating Our Balls Enough?

The Food and Drug Administration has approved a pathogen reduction (PR) process for platelets. For much of my career, this would have been as big a deal as finding the grail. But, in the weeks since, I have heard (a not unexpected chorus) telling me that “we” cannot afford it. There are two “we’s” in this opera. The first is the blood community, living with the realities of DRG (diagnosis related group) reimbursement and horrid pressures to cut our prices to hospitals. It will cost more than $50 per platelet dose, and we do not think we can pass it through. The second “we” is the hospitals. They may have higher safety priorities (consider healthcare-associated infections, medication errors, falls), and don’t think the main driver for platelet PR – bacterial contamination of platelets – merits the use of limited resources. I would have more sympathy for the latter argument if I believed dollars not spent to fix platelet sepsis would be diverted to the “larger” issues. Read Full Post >


I Didn’t Know What I Didn’t Know

I’d like to tell you I entered the Army solely out of patriotism. The truth is, my father strongly suggested it because he thought I was lazy and undisciplined. As it turned out, it was an excellent experience and a strong sense of patriotism eventually followed. I often wondered if I would have developed a similar sense of responsibility without the rather abrupt culture change introduced by my basic training drill sergeant and nine years in the Army. In retrospect, I think my military service accelerated changes that would have occurred regardless as I matured. Then again, compared to my father, I’m still lazy and undisciplined. Read Full Post >


Bring Back the Table

Is it time to bring back the big table for ABC Member Meetings? ABC’s history is rooted in a time when business was conducted with every ABC member CEO seated at a large rectangular table. The story goes that the table got bigger and bigger. Eventually a new leadership paradigm was necessary, and our current governance model with a board of directors was born. Read Full Post >


Introducing the ABC Business Forum

By now, I hope you have had a chance to review the upcoming ABC Annual Meeting program. You will notice an interesting new addition to the program: “The ABC Business Forum: The Economics of Plasma,” on Saturday, March 21. This addition could not be timelier or more relevant. First, it complements the executive management and scientific and medical discussions in the Blood Center Leadership and SMT Forums by providing valuable information and education on the operations side of blood banking. Second, it ties in with ABC’s current advocacy agenda on the issue of plasma flexibility. Read Full Post >


Vote Early and Vote Often

Brace yourself. Get ready … “ABC’s Got Talent” has arrived! Experience ABC supporters including CEOs, blood center employees, and even family members and friends of blood centers like you’ve never seen them before, all while raising money for a good cause. This week kicks off “ABC’s Got Talent,” a truly fun fundraiser. So, what do you need to do? Read Full Post >


The Value of Blood

I’ve long been fascinated by cost accounting in blood bank operations. We often talk about the cost of producing a red cell unit. But is this the right way to think about our costs? I do not think so. Read Full Post >


'Tis The Season

As the holidays approach, many begin to ponder which charitable organizations they would like to support. We hope that you consider the Foundation for America’s Blood Centers (FABC) in your charitable gift planning this year! 2014 has been an exciting year for both ABC and the FABC. Read Full Post >


Washington Matters

The Food and Drug Administration is working with ABC and the blood community to promote the most efficient use of apheresis plasma from unpaid volunteer donors for further manufacturing into life-saving derivatives, according to Jay Epstein, MD, director of FDA’s Office of Blood Research and Review (OBRR) in the Center for Biologics Evaluation and Research (CBER). An ABC delegation including President Dave Green, President-Elect Susan Rossmann, MD, PhD, Chief Medical Officer Louis Katz, MD, and myself, met at the FDA White Oak campus yesterday with OBRR representatives to discuss these plasma requirements and other topics of interest to ABC members. In addition to Dr. Epstein, key members of the OBRR leadership team participated in the meeting. Read Full Post >


Paving the Way for the ABC Professional Institute

Last week, members of the ABC Professional Institute (API) Curriculum Development Committee, and invited guests, gathered in the ABC office for a retreat to scope out and prioritize the services and products offered to members through the API, which is currently under development. Led by committee chair and facilitator, Michelle Johnson, from Carter BloodCare, the group spent a day sorting through the results of a recent membership survey about the API, and worked to identify the content of potential subjects and certificate programs that would be of value to ABC members. Read Full Post >


Déjà Vu All Over Again?

The year 2004 saw the Summer Olympics return to its starting place in Athens, Greece. New England dominated the USA professional sports world with the New England Patriots winning the Super Bowl and the Red Sox the World Series. Oh – and red cell demand for independent blood centers was approximately the same as it is today. What happened to the decline in demand!? Read Full Post >


How Do We Honor an Industry Visionary?

Earlier this year, we lost a respected leader in the blood banking community – one who was recognized for his financial acumen, industry vision, and perhaps most importantly, his ability to put aside personal feelings and unite those with opposing viewpoints for the greater good. Jerry Haarmann, who you likely know as the guiding force behind Group Services for America’s Blood Centers (GSABC), was not only a visionary, but also a friend and mentor to many of us. Read Full Post >


Still Time to Let Your Talent Shine

Who said blood bankers’ talents are restricted to the blood center? Since we first introduced “ABC’s Got Talent,” the online virtual talent show fundraiser benefiting the Foundation for America’s Blood Centers (FABC), we have learned that our members have a multitude of rare and exciting talents. I do not want to give away any spoilers, but let me just say, blood bankers sure do keep things interesting. Read Full Post >


It’s the Vaccine Stupid!

The time is approaching for seasonal flu shots. In the US, uptake of flu vaccine on an annual basis remains disappointing. The Centers for Disease Control and Prevention estimates that only 42 per-cent of adults and 59 percent of kids were immunized during the last flu season. (I always remember the last time I missed my shot, in 1976 when I was an intern, and got influenza A while as-signed to a Department of Veterans Affairs medical ward. I was afraid I was not going to die.) The best thing I ever did in health care was to push for – and finally see – implementation of mandatory flu immunization in the hospital where I worked for 30 years. This came after it became clear that rational, evidence-based appeals to patient and personal safety were met with unacceptable vaccine uptake. Read Full Post >


Three Days in the Life

It’s the bowling pins on the corner table, each decorated in a different human form, complete with faces and clothes, that grab your attention immediately upon entering the reception area. Looking up, there is less than an inch between each of the photos featuring smiling blood donors lining every wall, heralding the gallons given by community members. Handmade quilts warm the walls of the donor room. The phlebotomist smiles, welcoming a favorite donor and neighbor. Recruiters don funny glasses and a fake mustache to add a personal touch of humor when scheduling the next appointment. Read Full Post >


The Light at the End of the Tunnel May be the Train

AABB’s Standards have required “methods to limit and to detect or inactivate bacteria in all platelet compo-nents” for almost 10 years. In 2012, the Blood Products Advisory Committee (BPAC) voted that “additional measures are needed to decrease the current risk of transfusion of bacterially-contaminated platelet products,” and FDA is writing guidance that will standardize our approaches. ABC centers are asking me about the pend-ing guidance, but guessing the timing or content of agency guidance is not often fruitful; however, the op-tions available aren’t rocket science. Read Full Post >


Tomorrow’s Donor Base — Take Two

Last week in this space, ABC President Dave Green wondered about the makeup of tomorrow’s donor base to meet future transfusion needs. He correctly stated that finding the right answer in the current environment is key. With other seemingly more urgent priorities, he urged us not to lose sight of this issue and to ensure donor relationship management practices are prepared to recruit and retain future donors. Dave, I’m glad you brought it up! Read Full Post >


Tomorrow’s Donor Base

What will our donor base need to look like to meet the transfusion needs of tomorrow? This is perhaps an odd question to ask when the past five years have been characterized by unprecedented declines in blood use and a struggle to take out capacity and reduce costs. Answering this question can also be easily postponed in favor of identifying solutions to near-term problems like chikungunya virus, or resolving long-term issues, such as our inability to convert concurrent plasma for fractionation. But it will require an answer nonetheless, and I believe it will constitute a major challenge for us all. Read Full Post >


With a Little Help From Our Friends

Last week, the blood community and 10 organizations representing patients with rare diseases sent letters to the Food and Drug Administration in support of the blood community’s initiative for regulatory harmonization. Specifically, these organizations are seeking the regulatory flexibility for blood centers to manage apheresis plasma efficiently, as they do recovered plasma from whole blood, so that it can be shipped for manufacture into plasma protein therapies at any time after collection. This regulatory change will advance population health by addressing the unique needs of patients with rare diseases that use life-saving plasma protein therapies. Read Full Post >


Never Fail to Astonish the Customer

“Be everywhere, do everything, and never fail to astonish the customer.” For an avid shopper like myself, it is hard for me to find fault with Macy’s, the retail giant who developed this customer service mantra. But as an association aiming to not only provide excellent customer service, but also valuable resources, information, and programs to a diverse membership, we have recently taken to focusing on delivering on our four core values (Innovation, Data Integration, Education and Advocacy), instead of providing the “everything.” Read Full Post >


Ebola R’ Us?

I am fielding questions from my blood bank pals about any impact of the Ebola epidemic in West Africa on transfusion medicine here. I understand Ebola transmission dynamics in the context of the deleterious impact of lack of development (and mistrust of “experts”) in sub-Saharan Africa compared to here. As a result, I pretty much dismissed Ebola as an important threat to what we do in the US – even given the lightning speed of international travel, as discussed in this week’s commentary by Anthony S. Fauci, MD, in The New Eng-land Journal of Medicine. Read Full Post >


Making the Case for Big Data (aka, ABC’s Data Warehouse)

On July 22, America’s Blood Centers Data Warehouse Requirements Advisory Committee (DWRAC) held its first face-to-face member meeting in Chicago. We sought to define how the warehouse can be used to help member organizations identify opportunities for improvement and support national ABC advocacy efforts that represent our views. Read Full Post >


Bylaws Anyone?

Once again, ABC’s board of directors will hold an open bylaws hearing at the upcoming Summer Meeting in Seattle at 7 a.m. on Aug. 7, prior to the scheduled 8 a.m. Members Meeting to vote on several amendments to ABC’s bylaws. This hearing follows a webinar on the ABC bylaws amendments held earlier this week, during which Rick Axelrod, MD, ABC’s vice president and chair of the Bylaws Committee, discussed the amendments proposed by the Bylaws Committee. The hearing is intended to offer ample opportunity for members to raise questions or concerns regarding the changes contemplated. A cursory review of the changes may suggest minimal controversy and maximum “tweaking;” indeed, there are many minor changes included. Yet I strongly encourage your participation in the open hearing and careful consideration before voting. Read Full Post >


Backyard Games and Blood Bankers

You may have heard about the Foundation for America’s Blood Centers’ Cornament and Silent Auction taking place at America’s Blood Centers’ Summer Meeting in Seattle on Aug. 5 and wondered what a bean bag toss game – generally reserved for backyard barbeques – or a silent auction – generally found at black tie events – has to do with the ABC Summer Meeting. The answer is not a whole lot. However, what we hope to accomplish through these events is to provide our member and industry supporters with more opportunities to learn about the programs that are funded through the FABC and why we continuously need your support. Read Full Post >


Backyard Games and Blood Bankers

You may have heard about the Foundation for America’s Blood Centers’ Cornament and Silent Auction taking place at America’s Blood Centers’ Summer Meeting in Seattle on Aug. 5 and wondered what a bean bag toss game – generally reserved for backyard barbeques – or a silent auction – generally found at black tie events – has to do with the ABC Summer Meeting. The answer is not a whole lot. However, what we hope to accomplish through these events is to provide our member and industry supporters with more opportunities to learn about the programs that are funded through the FABC and why we continuously need your support. Read Full Post >


Iron or Rust? A Meta-Analysis on Blood Donor Iron Supplementation

Stephen Vamvakas, MD, PhD, a master of meta-analysis, used to quip that performing meta-analyses means never having to do your own study! Meta-analyses combine similar studies to increase statistical power of conclusions. The Cochrane group recently analyzed blood donor iron stores and replacement. Read Full Post >


The Sting of Transparency

There is an increasing movement toward pricing transparency for hospitals and providers. As previously reported in the ABC Newsletter, the Centers for Medicare & Medicaid Services has released massive databases with information on Medicare payments to hospitals, physicians, and other non-hospital providers. In addition, three large insurers have announced that they are establishing a similar online database of paid claims. Also evolving very rapidly are state-level All-Payer Claims Databases (APCDs). More than 30 states have established or shown a strong interest in APCDs, large databases that systematically collect medical claims, pharmacy claims, and provider files from private and governmental payers to obtain multipayer data that allow stakeholders to understand the cost, quality, and utilization of health care in their region. Read Full Post >


Meet Us In Seattle

What’s not to love about the emerald city? The modern skyline, the futuristic space needle, the coffee culture, the lush green surroundings, and the Cascades – add to that the ABC Summer Meeting – and you’ve got a perfect summer getaway! We are heading to Seattle and we couldn’t be happier with the program. Puget Sound Blood Center will be hosting the 52nd Summer Meeting and we hope that you will meet us there. Read Full Post >


State Fairs and Blood Bank Associations

The York County Fair happens once every year and when I was growing up back in south central Penn-sylvania, it was exciting for me to attend the fair. I got much the same feeling last month when I was fortunate enough to be able to attend a couple of state blood bank annual meetings for the first time in a few years. Read Full Post >


On “Big Data”

I have been extremely fortunate over the years to have known some exceptional thinkers, strategists, and visionaries. Their counsel has been instrumental in whatever success I have enjoyed, and in the case of those mentors outside blood banking, their insights into the challenges and opportunities that they have faced in their respective industries and which may impact our world, have been quite instructive. Such is the case with a board member and mentor from my former employer, who happens to also own a bank (I’ll call him Joe). Read Full Post >


The Buck Stops ... Where?

America’s Blood Centers’ board of directors owns responsibility for the performance of ABC. As is the case with any organization, the buck stops with the directors and officers. Granted, boards hire, evaluate, compensate, and retain a CEO with the expectation that this individual will oversee the operations of the enterprise. But in doing so, boards must step up and not blindly follow the lead of the CEO. Rather, they must spend considerable time on strategic issues such as oversight, planning, enviro-scanning and assessing organizational risk. ABC’s board is doing just that. Read Full Post >


The Catchphrase Patient Blood Management has Been Hijacked!

Appropriate transfusion is good for patients. Blood transfusion saves lives every day. However, benefits of transfusion are not included among the data collected by patient blood management (PBM) and hemovigilance programs. We need to develop indicators and count successes of transfusions therapy. Read Full Post >


Together is Always Better

A lot has changed in the past three months. While my days of caring for a newborn have been filled with diapers, feedings, and copious amounts of coffee, my colleagues at America’s Blood Centers have been working diligently to continue to strategize and implement ways to better align ourselves with the needs of ABC member organizations. I was happy to hear that part of this strategy is to officially merge my work with the Foundation for America’s Blood Centers (FABC) with the work of the Member and External Relations department at ABC. Read Full Post >


Coming Soon to a Screen Near You: Your One Source for Blood Banking Staff Development and Learning

It has never been easier to access information – with the click of a mouse and a few key strokes, you can find just about anything on the Internet. For trade associations and customer service organizations alike, it has become clear that an organization’s website is crucial to its success. An entity’s website serves as its “public face” and is generally the first place customers look to answer questions or find resources. Read Full Post >


Collective Responsibility is Red, White, and Blue

Collective responsibility is an elementary principle of organizational life. ABC members have the opportunity to vote on two bylaw changes via webinar on May 14, 2014 at 2 p.m. EDT or by submitting a proxy ballot by COB May 12. Read Full Post >


Don’t Say I Haven’t Said Anything Nice About FDA Recently

The Food and Drug Administration’s Center for Biologics Evaluation and Research and Center for De-vices and Radiological Health has issued a draft guidance (available at http://1.usa.gov/1nEBjUq). It describes the statutory and regulatory foundations permitting the agency to approve “Premarket Approval” (PMA) applications for medical devices even when all of the data that FDA requires are not available at the time of approval. The lynchpin is that “FDA believes that applying postmarket controls in order to reduce premarket data collection, when appropriate, improves patient access to safe and effective medical devices that are important to the public health.” The Food, Drug and Cosmetics Act requires that FDA use the “least burdensome” data requests to establish the effectiveness of a device and that “probable benefits” be weighed against “probable risks.” Read Full Post >


On Advocacy

This week’s ABC Newsletter details our active advocacy agenda developed by the Government Affairs Committee, based on your input. We have an ambitious agenda designed to tackle some long-standing issues, as well as emerging opportunities. Our overall intent is to shape the legislative and regulatory environment in a way that enhances our members’ ability to succeed in a challenging and fluid era. The ABC staff is capable and prepared to drive this agenda, but of critical importance is the active engagement by all of us in educating our national and local elected and administrative officials about the importance of these initiatives. Read Full Post >


Eventually We’ll Get It Right

There’s nothing like a reunion for making you feel old – and different, and special, perhaps. Last week, I went to the 25th reunion of my medical school class (Baylor College of Medicine, 1989). The events seemed to represent what’s happening in health care today, specifically some of the issues facing America’s Blood Centers. Read Full Post >


Not Much Happening in the Real World, So I’ll Update You On Mine

Chikungunya virus - named from a word in the Kimakonde language meaning "to become contorted," describing the stooped over appearance of its victims crippled with joint pain. This acute mosquito-borne infection of African origin has caused titanic epidemics in the Indian Ocean and South Asia during the past decade. Since early December 2013, more than 20,000 cases have been detected in the Caribbean and northern South America. There is no reason not to expect it to land on the US mainland, where competent vectors are common. The AABB Transfusion Transmitted Disease (TTD) Committee's Emerging Infections subgroup and FDA's Division of Emerging and Transfusion Transmitted Diseases have all been following the Caribbean outbreak closely. Read Full Post >


Information + Engagement = Good Decisions

Last week, America’s Blood Centers’ members came together in Palm Springs, Calif., for the 52nd Annual Meeting and 4th annual Links for Life Golf Tournament benefiting the Foundation for America’s Blood Centers. The work that went into organizing this particular meeting was unprecedented, not only for co-hosts Blood Systems, Inc. and LifeStream, as well as the ABC Meetings Committee, but also for the ABC staff. Read Full Post >


On Collegiality

Benjamin Graham was a noted Columbia Business School professor, author of “The Intelligent Investor,” and developer of the approach called Value Investing, on which Warren Buffett based his investment strategy. Ben Graham offered the following regarding cooperation and competition: “Competition creates better products, alliances create better companies.” This simple but compelling sentiment underlies in part the perspective on which the “Cooperate-to-Compete” theme, which has been incorporated into ABC’s meetings, is based. I would argue, however, there is an even more basic component to our long term success – maintaining our sense of collegiality. Read Full Post >


File Under the Heading of “No Good Deed Goes Unpunished”

related acute lung injury (TRALI) mitigation. They require whole blood and plasma for transfusion to come from donors who are unlikely to be alloimmunized to human leukocyte antigens (HLA), which have been associated with the risk of this transfusion reaction. It is a good bet that in the future, these expectations will expand to include apheresis platelet donors. A common approach to meet the Standards is screening donors at risk for alloimmunization for HLA antibodies using any of a variety of test kits. During recent Clinical Laboratory Improvement Amendments (CLIA) inspections of blood establishments, certain laboratories have been cited when testing for HLA antibodies because they are not CLIA-certified in the specialty of histocompatibility. At AABB’s request, CLIA has reviewed the issue and is maintaining this interpretation; so it is reasonable to expect more such citations. Read Full Post >


Shifting Organizational Culture Through Project Management

It has been slightly more than four years since I joined you in the blood industry, and what a four years it has been. While my tenure in our industry is short, I do understand rapid change and the challenges it creates for organizations and leaders, regardless of the industry. Evidence indicates that the changes we are experiencing in blood banking and healthcare at-large are unprecedented, creating tremendous challenges in our centers and in ourselves as leaders. The reality is clear – it’s not business as usual anymore. Read Full Post >


The Clock is Ticking

Whether talking about America’s Blood Centers or our member centers, there are two rudimentary contribu-tors to the financial equation. Decreasing costs and increasing revenue are essential to the bottom line. Sometimes trimming costs can be a delicate proposition. The need to meet or exceed member needs now and in the future must be balanced with the handling of short-term priorities. Often alternative sources of revenue are difficult to find. I would like to share with you today some of ABC’s activities to reduce costs and increase revenue as we strive to assure financial accountability to our members. Read Full Post >


Reconnecting Value to Satisfaction

Last week, the ABC board of directors, executive staff, and a handful of ABC committee chairs participated in the strategic “thinking” retreat in Dallas to develop the next strategic plan for your association. You will have an opportunity to review the draft plan in the coming weeks, prior to the Annual Meeting in Palm Springs, Calif., but before we get to that, I wanted to reflect on a point that was discussed at the retreat. Read Full Post >


We Need Your Voice

Blood Bank of Alaska (BBA) has many unique challenges due to our geographic location in relation to the lower 48, and the size of our service area. Alaska itself represents about 20 percent of the US landmass. No offense to Texas, but Alaska could easily fit two states the size of Texas within its borders with room to spare. Read Full Post >


Framing the Challenge: Decline or Shift

Not surprisingly the pace of change in how we interact with and support our hospitals continues at a brisk pace: hospitals joining systems, systems merging with systems, and mega-systems forming purchasing umbrellas. Our members are demonstrating creativity in expanding relationships with their customers, partnering to deliver unprecedented value, and forging new networks to extend their reach according to the evolving footprint of their customers. Amid these dramatic responses to an increasingly complex service environment, what responsibility do we have in making our donors aware of these changes? Read Full Post >


A Personal Reflection

It must be unusual for a single generation of docs to witness the glorious progress we have seen in the ability to control conditions that helped define a clinical epoch. Last week, the ABC Newsletter reported on two studies in the New England Journal of Medicine that described a treatment administered once daily for HCV infection with very well tolerated, all-oral drug regimens; these stand to replace some dauntingly toxic, injectable standard cocktails. They afforded apparent cure of infection in more than 90 percent of enrolled patients. The responses were independent of virus strain and other predictors of a poor response. Many giddily predict that we are seeing the coffin lid nailed down on a bug that is a leading cause for liver transplantation in this country and of end stage liver disease worldwide. Similarly, stepwise improvements since the mid-1990s in the ability to control – if not cure – HIV infection, have turned an infection associated with millions of grizzly deaths into a chronic process that under the right circumstances is held at bay with a single daily pill. Read Full Post >


Get Out of the Cold and Onto the Course

As much of the country continues to endure what seems like one polar vortex after another, many of us are holding out hope that Punxsutawney Phil does not see his shadow. However, instead of relying on a rodent to bring sunny weather, you should set your sights on the ABC Annual Meeting and Links for Life Golf Tournament in sunny Palm Springs, Calif. this March! Not only will you get out of the cold, but you will have the opportunity to support the Foundation for America’s Blood Centers (FABC) and have a great time golfing at one of the top golf destinations in the world. Read Full Post >


The Sustainability of Community Blood Centers

Sustainability has been generating much discussion within blood banking, and I believe there are three pillars of sustainability for community blood centers. The first is the continuing relevance of blood in medicine and surgery. A 2013 report on the blood banking industry by John Zeman and other experts suggest the demand for blood products and services will continue for the foreseeable future. The second pillar of sustainability is the market in which we operate, the changing realities of healthcare economics, and the supply chain. The third pillar is the business model(s) we select, or the “winning model(s).” There will likely continue to be winners and losers. I suspect not all winners will be large organizational entities, nor will all losers be small. Winning delivery models will be those blood centers that best execute what behavioral economics calls game theory, in which rational strategies and actions trump emotional attachments and decisions poorly grounded in realism. Read Full Post >


Be It Resolved

Happy new year! I hope your holiday season was filled with good health and much happiness. As so many do, I have put together a brief list of new year’s resolutions for 2014. Here are my top three. Read Full Post >


What’s Your Five Year Plan?

Much has been written about the uncertain times in blood banking, mainly due to the cost-cutting pressures within healthcare and the decrease in blood use. But something else is happening that has caught the attention of America’s Blood Centers’ executives – “en masse” retirements. In the last three months, three ABC member CEOs have turned over. The median age of an ABC member CEO or representative is 61, roughly five years away from retirement. We are facing a wave of baby boomers leaving the industry, which has implications not only to the communities they serve, but also to our association. Read Full Post >


‘Tis the Season

Every December, there is a flurry of association activity in Washington, D.C. ‘Tis the season for professional and trade organizations to finalize their federal advocacy agendas for the upcoming year. Read Full Post >


Disrupt Yourself

From Puget Sound, Wash. to Miami Beach, Fla., change is pervasive across the blood world. Community blood centers that were once unshakably loyal are seeking new leadership and value from America’s Blood Centers to guide them through a business climate that is almost unrecognizable from just a few years ago. This competitive and economically challenging environment has transformed member expectations, and the time is now to lead our organization into this new era, which is all about value to our blood center members. Read Full Post >


What’s Our Community ROA?

A cursory review of recent blood banking operations literature points to a rather dramatic shift (or de-cline, if you prefer) in core blood product demand and many speculate we will see more of the same over the next few years. If this is true (and I happen to believe it is), then we have an obvious problem of over-capacity. In the for-profit world, such a dilemma typically triggers industry leaders to investigate two questions: What does the demand characteristic of the future look like (in other words, how much change, how fast, and what impact will it have on our breakeven point?) – and – What are the barriers to exit should we need to move resources to another purpose? I will leave the challenges that blood banking faces with using dated national market information for a subsequent article. But I want to tackle the second question by asking how non-profits in general, and blood banks in particular, evaluate the exit question. Read Full Post >


Thicker than Water

This month I accepted the position as CEO of America’s Blood Centers. It is a privilege to be given the opportunity to work with this wonderful organization. I believe ABC’s future is full of promise and I am excited about what lies ahead. I am also aware that most of you do not know me, so I’d like to take this opportunity to introduce myself a bit. Read Full Post >


Charity Begins at Home

“Charity begins at home, but should not end there.” This quote has a number of variations and has been attributed to many authors over the years, but in the end, it always drives home the same point: to help the world, you must first start with the members of your immediate family and community. Then, slowly but surely, the ripple effect takes place. Read Full Post >


The Government May be Shutdown, but we Still Need You

As the partial government shutdown closes in on the end of its second week, and the world nervously turns its attention to the possible default of the US Treasury, there is a rather somber attitude in Washington D.C. and all over the country. Many are experiencing the “trickle-down effect” of the shutdown. It really hit me when I visited the Starbucks by the ABC office at 8 a.m. the other day. Normally, this particular branch tends to have a line out the door of caffeine junkies getting their fix, especially during the morning, but I was the only customer in the whole café that morning. The baristas confirmed it has been like that all week. Read Full Post >


Embracing Our New Leadership

On Sept. 20, America’s Blood Centers announced the hiring of Christine Zambricki, DNAP, CRNA, as ABC’s new CEO. I hope readers were as impressed as ABC staff was with her experience, skills, and qualifications. With her healthcare advocacy background, we couldn’t have asked for a better candidate to lead ABC at this very moment. Getting to Dr. Zambricki was not an easy process by any means. For starters, the ABC CEO Search Committee had to begin the search much earlier than anticipated. Thankfully, they were able to quickly develop search criteria that clearly defined the characteristics and skills of the new ABC leader. We were also fortunate to count on the assistance of a top talent search firm. The search firm initially reviewed 151 applicants, contacted 77, considered 11, interviewed eight and recommended four candidates to the committee. The Search Committee further narrowed the search to three candidates who appeared to meet the job description and desired CEO profile. After a round of interviews with committee members, Dr. Zambricki emerged as the top candidate and enthusiastically accepted the offer. Read Full Post >


Value-Added Services

I dislike the term “value-added.” I realize why the term exists and the importance of differentiating between delivering blood products and providing a comprehensive service approach to support hospitals. I just think the phrase somehow minimizes the very essence of the vital services that are often called “value-added." Read Full Post >


Leveraging Talents for Success

As this Newsletter goes to print, America’s Blood Centers’ 12th bi-annual Financial Management Work-shop will coming to a close. It is amazing how far this workshop has progressed since 1990 when a group of accountants, including me, decided that blood center financial professionals needed an opportunity to come together and share ideas. At this year’s workshop, titled “Financial Management: Thinking Strategically in an Uncertain World,” we discussed the “State of the Industry” from the blood center executive, supplier, and hospital viewpoints. Attendees heard presentations addressing whether our business models are sustainable, shared success stories on how to enhance the bottom-line, and much more. Read Full Post >


Jason and the Algorithms

I distinctly recall my aunt and uncle taking my cousins and me to a drive-in theater back in 1963 to see that year’s big special-effects film, “Jason and the Argonauts.” Based on Greek mythology, the hero Jason stood before Zeus and Hera in the heavenly Olympus and received direct guidance about how he might find and steal the Golden Fleece, which reminds me now of how I attend ABC meetings to derive enlightenment from conversations with my mythic colleagues at ABC. The gods offered Jason some support, but ultimately, he had to overcome many obstacles himself. There were two images from that film that remain vivid in my mind to this day. The first was when Jason battled the Hydra. Jason had to kill the many-headed monster in order to make off with the Golden Fleece. The other was the frightening moment when the skeletons broke out from the rocky earth with their swords and began battling Jason and his men. Read Full Post >


“Star Wars” or Looking for Trouble?

I always told my kids to be careful turning over rocks – there might be a scorpion there to sting them. The warning came from my clinical experience, watching colleagues test patients for infections that you could tell they did not have after talking to the patient, and coming up with false positive tests to explain away. The pathologists among us (at least those beyond a certain age) will remember “febrile agglutinins” in this context. Read Full Post >


Change for the Better

There has been a whole lot of talk about change lately – nationally, locally, and even personally, change has been a common subject of conversation. Our national healthcare system is embarking on some of the most drastic changes in history. Lately, my Facebook page has been filled with endless posts of what may be considered the quintessential symbol of change in the lives of parents and children – the first day of school picture. And of course, as everyone in blood banking knows, our industry is changing at a fast and furious pace, with many discussions among blood bank leaders focusing on what we can do to keep up. Read Full Post >


Why do we do What we do?

Yes, I know the primary reason that we “do what we do” is to help connect donors and patients by providing life-saving blood products. In this case, I’m asking a less meaningful, but in some ways perhaps more provocative, question – How are blood centers organized and will that organizational structure allow us to continue to “do what we do” best? I’ve been in blood banking for nearly a quarter century, yet I did not really seriously wrestle with this question until recently. Perhaps my reticence stemmed from needing a certain level of predictability in how I saw our role in the community, or that previous challenges did not require us to tackle these types of questions. However, I believe those answers are critical now. Read Full Post >


America's Blood Centers: Power in Numbers

You may already be aware, either by attending or hearing about it, that America’s Blood Centers just completed a very successful Summer Meeting (formerly the Interim Meeting). The meeting provided a great opportunity to reconnect with old friends while also making new ones. The BloodCenter of Wisconsin was the perfect host, even providing fantastic weather. Read Full Post >


Three Kinds of Lies: Lies, Damned Lies, and Statistics

Two recent reports appeared separately in the ABC Newsletter. The Healthcare Cost and Utilization Project (HCUP) Statistical Brief, #149 from the federal Agency for Healthcare Research and Quality lists transfusion as the most frequent procedure performed in US hospitals during 2010, while the 2011 National Blood Collection and Utilization Survey (NBCUS) shows significant decreases in blood transfusions since 2008. I have received inquiries about the apparent discrepancy between the reports, but there is probably no conflict – they count apples and oranges. Read Full Post >


To Shape the Future, Get Involved

Earlier this week, the Department of Health and Human Services published the 2011 National Blood Collection and Utilization Survey (NBCUS) Report (see page 1). The results will come as no surprise to blood bankers: blood collections are down, driven by the decrease in demand and perhaps the increase in patient blood management strategies. Overall, there has been about an 8 percent decrease in whole blood and red blood cell (RBC) transfusions – echoing what ABC members have reported and similar to rates reported by European Blood Alliance members. Read Full Post >


What on Earth do Railroads Have to do with Blood Banking?

I admit I was a bit skeptical when I learned that ABC’s Meetings Committee had arranged to have Mark Fagan from Harvard deliver a two hour presentation on how the railroad industry offers us insights into our unprecedented environmental challenges. After all, what do railroads have in common with blood banks? Following the truly dynamic and interactive session by Mr. Fagan at last March’s ABC Annual Meeting, I (and I believe other attendees) awakened to the incredible wealth of knowledge other indus-tries could offer in helping us thrive in difficult times. Based on the immensely positive feedback on this session, the Meetings Committee planned for the August ABC Interim Meeting in Milwaukee to build on the discussion started in March by welcoming Mr. Fagan back to help guide us through a discussion on how ABC should deliver value to you – ABC’s member blood centers. Read Full Post >


Let Our Past be Our Rock for the Future

Sometimes when you seem overwhelmed by the challenges of the future, it is comforting to look back at the past. Not that the challenges of the past were less daunting, but knowing that we met those challenges and survived brings peace of mind. Read Full Post >


The Perfect Sunny Day?

There’s the proverbial expression of what happens when many bad variables converge to bring us a “perfect storm.” I wondered recently what we might call it if industry, regulatory, and economic factors all became aligned after decades of discussion to finally bring us pathogen reduction (PR) for US blood products. Were that to happen, might we call this a “perfect sunny day?” Read Full Post >


Risk-Based Decision Making: More Questions than Answers?

There is international consensus that risk-based decision making’s time has come to the blood community. Diverse groups including, the Alliance of Blood Operators (an international group of national blood systems), and more recently, the Food and Drug Administration endorse it as the appropriate framework for creating transfusion safety policies. It’s hard to argue otherwise. In our arena, its foundation lies in understanding two things: resources for blood safety are limited and zero-risk is not attainable. Given the former, recognizing the latter leaves us with hard questions. At the top of the list is answering the question “How safe is safe enough?” – to which we respond, “According to whom?” Read Full Post >


Help Us Help You

Last year, America’s Blood Centers conducted its SEQuaLS member satisfaction survey, where ABC members could pose questions to the ABC and Foundation for America’s Blood Centers staff. One member asked, “Is there a way to make more grants available to member centers?” To provide the short answer – yes, the FABC is working to provide more useful grants to ABC members, but let’s start at the beginning. Read Full Post >


My Crystal Ball is Hazy

Either the strategic drivers shaping the blood community’s environment are at an all time high of flux, or I am suffering from bilateral uveitis – perhaps it is both. Regardless, my crystal ball has never been less clear. Read Full Post >


What Happened to the “I” ?

The acronym for America’s Blood Centers’ “core values,” IDEA, represents Innovation, Data Integration and Benchmarking, Education and Networking, and Advocacy. Although these values are not unique in themselves, they become powerful tools for ABC to serve its members. These tools are where the knowledge and leverage of all outweigh that of one. Read Full Post >


You Ought to Tell the Donor That

A young man donated double red cells at our center about a week before running a marathon; not surprisingly, his performance was awful, and he was angry with us. We didn’t know he was planning to run, and he didn’t know that donating would hurt his performance. After we explained, he calmed down, and said, “Well, you ought to tell the donor that.” How right he was. More and more, we realize donors should know much more about donation, in advance, and we are getting more sophisticated about what to tell them, and how. Read Full Post >


Advocacy Works – Sometimes More Quickly than Other Times

One year ago, an ABC member blood center applied for a variance from Food and Drug Administration labeling regulations requiring results on red blood cell (RBC) labels to be from samples collected “at the time of filling the … blood container” and “on a specimen taken … at the time of collection.” The center requested permission for inclusion of historical RBC phenotyping and genotyping on the integral labels of RBCs (i.e., the base label or attached tie tags). Read Full Post >


Building a Strong Foundation

Since we realigned and streamlined our core values, we came to the realization that not all values are created equal. Some values depend on others to thrive and accomplish their goals. We rely on three values to deliver ABC’s mission of helping community blood centers: advocacy, networking and education, and data integration and benchmarking. Data, however, is at the foundation of our core values and it is through data that we meet goals related to the other two core values. Read Full Post >


On Being Obsessively Data Driven

When I wrote my first “Our Space” column several weeks ago, I shared a draft with my confidant and former medical director, Dr. Louis Katz. His feedback was predictably direct: “I dislike passive voice and it seems quite fluffy.” Although I agreed with his feedback, I approved the draft, believing my first piece should be a bit …well, fluffy. I hope he appreciates the more direct approach this week. Read Full Post >


"Alone, we can do so little; together we can do so much" —Helen Keller

When I sat at my desk to write this, my first article for Our Space, I wondered where I should start. Unfortunately, the tragic events of the last couple of weeks have provided a starting point. Read Full Post >


Helping the Helpers

As with so many, my heart is broken over the explosions at the Boston Marathon. Although I cannot fathom the trauma suffered by the victims, families, and witnesses affected, the fact that it happened at a race hits close to home. My husband and his brother have run numerous marathons, I have many friends who run, and I am running a ten miler this weekend. However, because of yet another senseless act of violence ,the excitement of crossing the finish line will be overshadowed by the worry of being one step away from a similar tragedy. Read Full Post >


“Generals are Always Prepared to Fight the Last War”

I was a bit surprised to open Streetlights and Shadows: Searching for the Keys to Adaptive Decision Making, a book by Gary Klein, and find a well-thought-out discussion of a conundrum that has been nagging me my entire career: how do we optimally balance critical thinking, experience, and independent judgment with standardized metrics, standard operating procedures (SOPs), checklists, and job aids? Within the highly regulated and structured environment that we live in today, it may be easy to conclude that SOPs, intensive methodical data gathering, and articulated logic are the ways to achieve optimal safety. While they are incredibly important, especially within transfusion medicine, real-life decision making is messy and often no amount of pre-planning or data gathering will eliminate all risk. Perhaps this is the lesson the precautionary principle is really trying to tell us. Read Full Post >


Of Root Canals, Traffic Jams, and Brussels Sprouts

A recent survey found that Congress is less popular than root canals, traffic jams, and Brussels sprouts. Between partisan wrangling, brinksmanship, and the challenge of coming to agreement, it’s no wonder many would prefer eating their vegetables to watching the legislative process. Read Full Post >


You are ABC

I want to congratulate and thank America’s Blood Centers’ Meetings Committee, ABC staff and members for an excellent Annual Meeting event. The topics were compelling, participant engagement was excellent, and a professional discourse of the highest caliber occurred throughout. These characteristics reflect an association founded on sound fundamentals, which despite our recent change in leadership remain the cornerstone of our work. Indeed, an unwavering focus on our core values as an association has never been more important. Our challenges are daunting, but ABC’s tradition of quality service over the years argues for optimism in the face of these hurdles. Working together, we can leverage our collective expertise and talents to help us continue delivering excellent service for our communities. Read Full Post >