Long-time employee and blood recipient Terrie Foster was awarded Canadian Blood Services’ national Living Our Values award this year. She was recognized for her exceptional standard of work, collaborative nature and commitment to excellence.
Maximizing the impact of our funding partners’ investment goes far beyond reducing and avoiding costs. The drivers of efficiency are woven into all aspects of our work, whether we’re simplifying the donation experience, implementing new productivity measures or enhancing our facilities to create better experiences for donors and employees.
The continuing evolution of our quality management system reinforces our commitment to the standards set by the global biologics manufacturing industry. As our processes and systems mature, we’re seeing steady improvement in key quality measures and outcomes.
Over the past year, Canadian Blood Services continued to roll out a program called Link: Strengthening Our Quality Management System and Culture. We’ve introduced a new set of requirements for change control — the management of all changes to our operating policies and procedures. We’ve also established an enhanced document management protocol. We’ve launched a quality-focused training program. And crucially, we’ve implemented a new process for corrective and preventive actions, or CAPAs.
The CAPA process remains a top priority for our executive management team. A cornerstone of an effective quality management system, it’s essential to our pursuit of continuous improvement and our commitment to ensuring donor and patient safety. Over 500 CAPAs were initiated in 2016–2017, a significant increase from previous years. Our longer-term goal is to handle 95 per cent of CAPAs within 30 days as we strive to address any departures from policies and procedures — what we call non-conformances — across our operations with timely and effective solutions.
We’ve made significant progress in reducing the already small number of blood products recalled as the result of errors or new information received from donors after they’ve given blood. Our target for the past year was fewer than 1,800 such recalls; the actual number was 1,430 or 14 per cent of all products distributed.
It's worth noting that recall rates, while a critically important quality measure, don’t necessarily indicate the entry of sub-par products into the system. The blanket term recall includes many situations in which we’re not correcting a problem but simply being vigilant and proactive. There were no extreme errors or accidents involving fresh blood products in 2016–2017, and 49 reports of adverse reactions.
We met all of the performance indicators on our quality index in two quarters of 2016–2017; two minor misses in the other two quarters prevented us from achieving a perfect score for the year. Overall, our performance was more consistent compared to previous years. And for the indicators we track that may point to quality issues — including hospital complaints, non-conformances, audit anomalies, loss of products and incomplete quality control data — both the number and range of incidents are generally going down. Alongside the small and declining number of recalls for products shipped to hospitals, the discard rate at our facilities has decreased significantly — further evidence of our commitment to quality and continuous improvement.
During the past year, as another indication of our organization's growing quality mindset, we delivered a new training module for all employees on the products and services we provide, and trained a key operational group on how to effectively analyze root causes and execute CAPAs. We implemented periodic reviews of all standard operating procedures across the organization to ensure documents are complete and accurate, and where we could, we eliminated redundant activities that didn’t contribute to advancing our safety and quality goals.
In the next 12 months, we’ll be introducing a quality policy that is aligned with the highest contemporary standards. We’ll also begin to automate quality processes to further improve their efficacy and efficiency. In short, we’re moving ahead in our quality journey, and the positive results we’re seeing today set the stage for further progress to come.
“Over the past year, we’ve improved the mechanics of our quality management system and introduced new quality-focused training. Recalls have gone down, and we’ve been more consistent than ever in meeting performance indicators. Now we hope to fully reap the benefits — and I’m confident we will.”
During a year in which we had to replace over half the number of blood donors because of changing eligibility criteria for blood donation, attrition and other factors, our digital channels were more important than ever. For recruitment, retention and engagement, we’re connecting with donors on their terms — and getting to know them better in the process.
As of March 2017, the average number of people who use our award-winning GiveBlood mobile app each month had increased by 76 per cent, compared to the previous year. Donors use the app to check eligibility criteria, make appointments at convenient collection sites and set up automatic reminders. Our database of mobile numbers had grown to 128,000 by year-end — an annual increase of 44 per cent. And 48,000 people had signed up to receive updates via our new SMS text messaging service.
Over the past year, the number of appointments booked online grew from 145,500 to over 325,000. In the same period we added over 208,000 new online donor accounts. And Canadian Blood Services became the first national blood operator to implement a chatbot: an application that responds intelligently to users’ queries and comments, conducting a virtual conversation. Such capabilities, which are especially attractive to younger prospective donors — the key to our future — also enable our contact centre employees to focus on queries requiring live interactions.
We now have over a quarter of a million email addresses in our national database, and the number of donors who prefer communicating by email continues to rise steadily. At the same time, social media plays an increasingly important role in donor engagement. We have more than 100,000 followers on our national Facebook page, some 60,000 followers on Twitter and are experimenting with Instagram and other channels to see which resonate most with current and potential donors. Over the coming year, we’ll continue to enhance our digital offering, inviting donors to choose how they prefer to connect with us.
In August 2016, Canadian Blood Services joined two dozen other blood operators in 21 countries in an international campaign to recruit future blood donors. Called Missing Type, the online campaign showcased logos and signs in everyday and landmark locations that were missing letters from the three main blood groups: A, B and O. By the end of the month 6,500 potential Canadian donors had registered at missingtype.ca, yielding a new pool of potential donors for our recruitment efforts.
The aim of our mobile and online engagement strategy is to bring more people into our physical collection sites — and here too we’re adjusting our presence in Canadian communities. For example, we’ve put more emphasis on our permanent sites in metropolitan areas and are beginning to offer more convenient access and opening hours for these large concentrations of potential donors. Urban sites can also provide more stable schedules for staff while serving donors efficiently at a proportionately lower labour cost per unit. But location is only one aspect of improving responsiveness and performance. Equally important is the move to a digitally enabled collection environment as part of our Automated Supply Chain initiative.
As we continue re-examining blood donation eligibility for men who have sex with men (MSM) — and develop criteria for trans donors — we must strike a balance between evidence-based research on blood safety and open dialogue with communities whose insights we need to hear. We’re committed to serving all Canadians, navigating a changing social context with sensitivity.
In August 2016, Health Canada approved our application to reduce the ineligibility period for MSM blood donors from five years to one year. This was another step in a long journey that began in the mid-1980s, when it was first recognized that blood donations from donors living with the human immunodeficiency virus (HIV) could pose a risk to the blood system. From that time until 2013, any male donor who had had sexual contact with another man was permanently ineligible to donate blood. In 2013, this lifetime ineligibility was reduced to five years following sexual contact with another man. Though changes have been made, for many in the LGBTQ community, progress has not been fast enough.
Most of the research that has informed donation criteria focused on MSM whose behaviours were deemed high-risk for infectious disease. To make eligibility criteria more inclusive and fair, we need evidence that clearly identifies groups with low-risk behaviours who can reasonably be allowed to donate without risking blood safety. This kind of research takes time and understandably tries the patience of LGBTQ donors who object to the idea that sexual orientation and high-risk behaviour are necessarily linked. Working with our scientific partners globally, we’re focusing our collective efforts — and making tangible progress.
To rethink blood donor eligibility criteria for men who have sex with men (MSM), we must first bridge a significant knowledge gap. To that end, in January 2017 Canadian Blood Services — in partnership with Héma-Québec, and with financial support from the Government of Canada — hosted a meeting in Ottawa that brought together national and international stakeholders to identify research priorities. The two-day gathering included researchers from a range of disciplines, as well as officials with Health Canada and international blood operators. Other stakeholders included representatives of patients who depend on blood products, and members of the LGBTQ community.
Experts from around the globe reviewed current practices and shared data on various approaches to MSM screening and their impact on the number of donors, blood safety and system operations. Smaller groups then met to determine what further research is needed. These sessions identified critical areas of study, ranging from individual, behaviour-based assessments to the use of risk modelling to evaluate alternative donor criteria.
Based on the outcome of this meeting, our Centre for Innovation launched a competitive MSM research grant program with funding provided by Health Canada. As this annual report went to press, 15 grant submissions from Canadian researchers were under review for funding in the summer of 2017.
In the past, there were no clear eligibility guidelines for blood donors who self-identified as trans. Screening practices varied from site to site, and this lack of consistency raised concerns in the trans community. In August 2016, after consulting with stakeholders about the best approaches to gathering personal data, we introduced national standardized screening criteria for trans donors. Once these criteria were shared publicly, however, individuals from the trans and gender non-binary communities strenuously challenged assumptions within the screening process that they felt revealed a lack of understanding about the nuances of gender and identity, as well as the diversity and complexity of individual experiences.
There are strong opinions within these communities on the need to shift the focus from surgery to high-risk behaviours. Committed to maintaining safety while ensuring all potential donors are treated with respect and dignity, Canadian Blood Services is working with community members to explore how we can further refine our screening approach. We’re also developing sensitivity training for all Canadian Blood Services employees, with opportunities for trans and gender non-binary individuals to be part of the process.
“Are we simply seeking to further shorten the time period [for deferred donations from men who have sex with men] but keep the targeted criteria for MSM? Or are we going to take a completely different approach … and embark on criteria that do not determine eligibility on the basis of gender or sexual orientation? These and other questions need to drive our research agenda — underscored, as always, by our evidence-based approach in determining donor criteria.”
In an internal survey conducted last year, our employee engagement score increased to 75 per cent — well above our 70 per cent target. This continuing upward trend reflects our efforts to build and sustain a high-commitment, high-performance culture across the organization and shows the dedication of our employees who come to work every day knowing they are making a difference.
Over the past year, we brought renewed energy and focus to recognizing the uniqueness of every person who works at Canadian Blood Services while promoting equity and a respect for difference across our organization. Among the highlights of our recent activities:
The results and recommendations from the inclusivity assessment are guiding development of a more comprehensive strategy through 2017–2018.
In 2016, Canadian Blood Services was recognized as one of Canada’s Safest Employers in the annual ranking conducted by Canadian Occupational Safety magazine, earning a silver award in the health-care category. Organizations are evaluated on a wide range of health and safety criteria, including employee training, management systems, emergency preparedness, incident investigation and innovation.
Other recognition over the past year included a Prism Award from the International Coach Federation for our employee coaching program, and a bronze award in the Cassies — the annual Canadian advertising competition focused on impact — for the GiveLife advertising campaign developed in partnership with Sandbox Advertising.
“We cannot deliver on our value proposition to Canadians without the dedication and commitment of everyone at Canadian Blood Services. We are working constantly to make this organization one of the best employers in Canada.”