title: Transportation Cooler Interventions Reduce Plasma and RBC Product Wastage.
abstract: OBJECTIVE
  The rate of plasma product wastage for the United States in 2011 was approximately 1.8%. The plasma wastage rate at our institution was higher, mainly due to products returned out of temperature range from procedural areas. A process review and intervention to reduce plasma wastage was undertaken, which included modifications to our transport cooler.
  
  
  METHODS
  A new cooler system was designed, and this device was implemented alongside an updated protocol for delivering plasma while also enhancing the previous RBC cooler validation time. We audited plasma and RBC product wastage prior to these interventions, from January 2013 to February 2014, vs after the intervention from April 2014 to March 2015.
  
  
  RESULTS
  After the intervention, the monthly plasma wastage rate declined 60% (12.6 units/100 units transfused preintervention vs 5.0 units/100 units transfused postintervention; P < .0001). The monthly RBC wastage rate also decreased 28% (3.2 units/100 units transfused preintervention vs 2.3 units/100 units transfused postintervention; P < .01).
  
  
  CONCLUSIONS
  Our intervention resulted in significantly decreased plasma and RBC wastage and is broadly applicable, since out-of-temperature product wastage in procedural areas is likely a significant problem at many institutions.
authors.affiliation: From the Departments of Pathology.
authors.forename: Ryan A
authors.initials: RA
authors.lastname: Metcalf
authors.affiliation: From the Departments of Pathology.
authors.forename: Steven Andrew
authors.initials: SA
authors.lastname: Baker
authors.affiliation: From the Departments of Pathology Medicine, Stanford University, Stanford, CA.
authors.forename: Lawrence Tim
authors.initials: LT
authors.lastname: Goodnough
authors.affiliation: From the Departments of Pathology nshah3@stanford.edu.
authors.forename: Neil
authors.initials: N
authors.lastname: Shah
mesh_terms: D001803:Blood Transfusion / Q000379:methods*; D006801:Humans; D008506:Medical Waste / Q000517:prevention & control*; D013048:Specimen Handling / Q000379:methods*
chemical_list: D008506:Medical Waste
keywords: Blood product; Cooler; Out-of-temperature; Plasma; RBC; Storage; Validation; Wastage