The Joplin Globe, Joplin, MO

April 10, 2013

Decline in need for blood leads to staff cuts at center

By Wally Kennedy
news@joplinglobe.com

— Decreased demand for blood transfusions is behind the recent decision by the Community Blood Center of the Ozarks to lay off 27 full-time and 12 part-time employees.

“We had a 15 percent decline in blood transfusions in the first three months of 2013 compared to the first three months of 2012,” said Chris Pilgrim, marketing manager for the blood center. “We just got the numbers for March. It was (down) almost 19 percent.

“That follows a decline of 4 to 7 percent in the last part of 2012.

Before the cuts, the center employed about 220 people. Pilgrim said officials hoped attrition would forestall the need for layoffs, but the drawdown in demand was too great.

“The decrease was so significant that in the end it became apparent that our budget and staffing would have to change immediately,” he said.

No employees of the Joplin Donor Center inside the main entrance to Northpark Mall were affected by the staffing cuts.

The center provides blood and blood products to 38 hospitals in a region that includes most of Southwest Missouri and Northwest Arkansas. Its clients include Mercy Hospital Joplin and Freeman Health System.

A spokeswoman for Freeman said overall blood usage there has not decreased, but it has at Mercy Hospital Joplin because of the May 2011 tornado.

Pilgrim said that nationwide, medical advancements and new surgical techniques are contributing to the decrease in the need for blood.



CELL SALVAGE

A big reason for the decline is that blood salvage devices are being used more frequently by hospitals. A recent report in Stanford Medicine Magazine, a publication of the Stanford University School of Medicine, states: “The cell salvage device has been around for decades, but only recently has evidence emerged that autotransfusion — giving patients their own blood instead of blood from donors — leads to better surgery outcomes.”

Cell salvage refers to medical procedures that clean and preserve a patient’s own blood cells, allowing recovery of blood that would otherwise be lost in surgery.

“As a result,” the report noted, “the use of the machines has gone from extremely rare to commonplace. Today, hospitals that have the machines use them in many scheduled abdominal and heart surgeries and routinely in trauma cases involving massive bleeding.”

At its national summit last fall, the American Medical Association brought attention to the subject when it identified the overuse of five medical treatments. Blood transfusions were on the list along with heart stents, ear tubes, antibiotics and inducing birth in pregnant women.

The Stanford report said: “Donated blood carries risks, albeit very slight, of infection and setting off an immune reaction. But research is also showing that even when these drastic outcomes are avoided, there’s something else about donated blood — which scientists don’t fully understand — that could slow recovery time or increase complications.”



JOPLIN HOSPITALS

Jeff Carrier, Freeman’s chief clinical officer, said blood demand at Freeman Health System has remained steady. Freeman is the only Level 2 trauma center in the region, meaning it receives the most critically ill or injured patients in the area. It also has seen an increased patient load after the tornado.

“Our blood usage does fluctuate based on patient needs, but there has not been a sharp decline in that regard at Freeman,” Carrier said. “We certainly value our partnership with CBCO and will continue to urge those in our community to participate in the many blood drives that Freeman and CBCO host yearly.”

At Mercy Hospital Joplin, which has used cell salvage technology for some time, blood usage has declined. That parallels a decline in patient volumes in the past year or so when compared with the patient volumes at the former St. John’s Regional Medical Center, which was destroyed by the tornado two years ago.

Dr. Susan Pintado, a pathologist with Mercy Hospital Joplin, said, “We anticipate an increase in blood utilization that reflects the current standard of care as we continue to add and expand our services.”



Latest trends

Pilgrim, with the blood center, said the layoff has affected “all areas of our business,” but even with the decline, it still takes 275 donations per day to meet the needs of 38 hospitals. The center schedules a number of blood drives each week around the region, such as the ones today at Galena (Kan.) High School and at College Heights Christian School in Joplin.

But Pilgrim said future blood drives in communities may be consolidated. Instead of having several dates in the same area, the center could merge them into a single community event.

“CBCO has always been true to our mission of providing all of the blood products necessary to meet patient needs,” said Don Thomson, executive director of the center. “We operate solely to serve the community in that regard. The latest blood usage trends warrant a modification in our budget and, unfortunately, in our staffing levels. We looked at all possible ways to avoid a reduction in that regard, but some cuts were unavoidable.

“These latest trends are due to medical advancements and new thinking, which is a positive thing overall for our community. We don’t know if current transfusion rates will continue, but we have demonstrated through the past 17 years that we will do whatever is necessary to meet the area’s blood needs in an efficient manner.”

Though usage levels have decreased for the time being, more than 5,000 blood transfusions still take place each month in area hospitals.

Said Thomson: “We still need blood donors to do what they do best, and that is save lives.”





Donor centers



IN ADDITION TO STAGING BLOOD DRIVES at area high schools, churches and businesses, the Community Blood Center of the Ozarks operates donor centers in Springfield and Joplin in Missouri, and in Springdale and Bentonville in Arkansas. Administrative offices are located in Springfield. Donations are accepted at the Joplin Donor Center at the main entrance inside Northpark Mall, 101 N. Range Line Road. Hours are 11 a.m. to 6 p.m. weekdays.