Quality management at the American Red Cross

According to the FDA, the American Red Cross is not as good at ensuring quality in the nation’s blood supply as it should be.  In fact, ” … despite $21 million in fines since 2003 and repeated promises to follow procedures intended to ensure the safety of the nation’s blood supply, it continues to fall short.”

This article describes some basic failures of quality management and illustrates some opportunities. For example, the Red Cross lacks a system to track errors (blood units that should not be introduced into the system) and hence has no mechanism to identify root causes and to develop solutions. 

Next, because it is a large ($2.1 billion in revenue) and decentralized organization (they use to have 53 operating regions and now 10) they lack uniform standard operating procedures.  Even when they have standard procedures, workers do not always follow them.  For example, a phlebotomist is suppose to swab a patient’s arm for 30 seconds and then let that area dry for 30 seconds, but those times are not always followed.  One solution is to make phlebotomists wear timing devices to ensure compliance. Another is to redesign the process to be more robust, especially with respect to ensuring that people comply with the standards.

The news is not all bad. A key lesson from quality management is the elimination of variability.  Red Cross workers sometimes forgot to ask all of the pre-screening questions to potential donors, thereby letting some donors pass even though they shouldn’t (e.g., if they had visited a malaria risk country).  To standardize the process, now potential donors must complete an on-line questionaire – the computer doesn’t forget to ask the question, so variability in the process is reduced.

NY Times 7/16/08 – Problems persist with Red Cross blood services


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