OA3-AM24-MN-15 - Utilizing Sankey Diagrams to Quantify Laboratory Efficiency of INTERCEPT Fibrinogen Complex vs Traditional Cryoprecipitate

Monday, October 21, 2024

9:45 AM - 10:45 AM

Location: 362

CE: Zero

Presenting Author(s)

DC

Dennis D. Chen, MPA, MLS(ASCP) (he/him/his)

Transfusion Medicine- Project Leader Information Technology
New York-Presbyterian/Weill Cornell Medical Center
Brooklyn, New York, United States

Disclosure information not submitted.

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Disclosure(s):

Tobias Cohen, MD, PhD: No financial relationships to disclose

Background/Case Studies: INTERCEPT Fibrinogen Complex (IFC) (Cerus Corp. Concord, CA) has a thawed shelf-life of 5 days while traditional cryoprecipitate (TC) has a thawed shelf-life of 6 hours. Pathogen inactivation technology facilitates this longer shelf-life. Due to this, IFC may promote more flexibility for thawing, returning and reissuing products and may require less overall lab technologist labor and time compared to TC. Sankey diagrams are a data visualization tool to map the flow from one state to another. We demonstrate here how Sankey diagrams provide easy quantification of tech time saved with IFC vs TC.

Study

Design/Methods:

As part of a yearlong clinical trial, the blood bank was randomized by month to use IFC or TC for all orders for cryoprecipitate transfusion in one hospital site. Our standard practice is to thaw TC on demand per order with a pre-thaw phone call for non-operating room orders. This phone call reduces TC wastage by preventing premature thawing. However, on IFC months, a standing set of 4 thawed IFC was always maintained in the blood bank and pre-thaw phone calls were not needed. Using data extracted from the laboratory information system and analysis in Microsoft Excel, the number of unique [source] [target] pairs (e.g. “[issue] to [transfuse]” vs. “[issue] to [return]”) were calculated and data were entered into Sankeymatic (www.sankeymatic.com) to generate a Sankey diagram (Figure 1) that reflects the various steps of the blood ordering and distribution process . Utilizing the Sankey diagram, we determined the total number of times various processes occurred and controlled for orders with multiple units, where the addition of a 2^nd simultaneous unit does not meaningfully increase tech time.

Results/Findings: IFC reissuing avoided 140 new thaw cycles whereas TC could only be reissued 34 times. Therefore, given an estimate of 10 minutes of tech time for a full thaw cycle, IFC saved 848 minutes during its 6 months of use vs TC. Similarly, IFC eliminates the need for calling bedside teams to confirm the patient is ready before thawing. This saves an additional 1,476 minutes (5 minutes per call) over 6 months. Finally, since fewer products are wasted, an additional 131 minutes of LIS product disposition entry (2 minutes per transaction) were avoided during the 6 months. In total, and annualized for a year, switching to IFC would free up about 82 hours of tech time which represents 4% of one technologist’s working hours and $4,428 in salary.

Conclusions:

Switching to IFC reduces tech time required to thaw and issue TC. Eliminating pre-thaw phone calls account for 60% of time savings. Even more time would be saved if accounting for the bedside team’s time spent receiving these calls. Any cost analysis of new blood products should also include labor costs and Sankey diagrams facilitate this calculation.