Ontario hospitals are facing a critical shortage of collection tubes needed for routine blood tests, forcing some hospitals to order staff to hold on to supplies and reconsider the number of blood tests they order for patients. patients.
But even with conservation strategies in place, some clinicians and lab staff worry that prolonged shortages or a significant disruption in supplies could affect patient care.
They warn that shortages are adding another challenge to hospitals stretched by pandemic pressures, and say monitoring the supply of blood collection tubes will be even more important as hospitals reopen operating rooms to scheduled surgeries that had been interrupted during the Omicron wave.
“This is by no means a stable situation,” said Dr. Catherine Streutker, chief and medical director of laboratory medicine at Unity Health Toronto. “At the moment we are doing well. But we expect the situation to be difficult for a few months.
“These shortages affect the majority of blood tests done at the hospital, and if we are unable to do them, it risks adversely affecting patient care.”
Shortages of blood collection tubes — linked to global supply chain stressors — began affecting hospitals in late December and have intensified in recent weeks, Streutker said.
By the end of January, Unity — which includes St. Michael’s Hospital and St. Joseph’s Health Center — had just a few days’ supply of blood collection tubes left and needed to seek help from nearby hospitals. A memo sent to staff on Jan. 31 outlining the supply issues said the network “was in crisis,” Streutker said, noting the warning had triggered a 10% reduction in tube usage at the hospital. .
“I am concerned about the surge in surgeries; this will increase the use of these tubes, which means we’ll run out of them faster if we can’t supply ourselves. »
Dr. Fahad Razak, a general internist at St. Michael’s, called blood tests a “cornerstone of the delivery of medical care” essential to the diagnosis, assessment and treatment of most hospitalized patients.
“In my career, there has never been a time when routine blood work – the very heart of our testing – has been threatened,” he said. “Right now it is affecting hospitals across the sector. But the supplies used for blood tests are the same ones used by family doctors… And so it will affect medical care in general if we run out of supplies.
Shortage blood collection tubes are known as vacutainers. Sterile glass or plastic tubes with colored rubber stoppers are used for routine blood testing in hospitals and community laboratory centers.
In a statement to The Star, global medical technology company BD (Becton Dickinson and Co.), a supplier of blood tubes used by some Ontario hospitals, noted that the pandemic has tested supply chains and has said COVID has resulted in “an ever-changing demand for the types and volumes of testing needed.
To meet increased demand for blood tubes, the company has ramped up manufacturing capacity and produced “nearly half a billion more blood tubes in 2021 compared to 2020,” a spokesperson said, adding that BD “will produce more hits in the next 12 months than ever.” before.”
The spokesperson added that limited raw material availability, labor shortages, and shipping and transportation delays have limited the company’s ability to scale up production even further.
Lisa Merkley, director of laboratory services operations at Sunnybrook, said BD notified the hospital in late December that it anticipated supply issues with its blood tubes. And while the company has been doing its best to allocate supplies to hospitals, it hasn’t been enough to meet the hospital’s demands, she said.
This led Sunnybrook to adopt strategies to reduce the use of blood tubes, said Dr. Adina Weinerman, medical director of quality and patient safety and staff physician in general internal medicine.
“We’re working in a resource-constrained environment, and it’s different than what you’re used to, and we need you to know that the amount of blood tests ordered at all levels needs to decrease,” Weinerman said, describing the message. handed over to the doctors at the hospital.
Although Sunnybrook hasn’t instituted specific benchmarks for a reduction in blood work, Weinerman said the hospital is following the recommendations of Choosing Wisely Canada, an evidence-based health education campaign designed to reduce unnecessary tests, treatments and procedures. She said there is evidence to suggest that up to 60% of blood tests carried out for hospitalized patients are “medically unnecessary” and that some studies show that the amount of blood drawn from these patients can cause harm.
“The students are showing that we can safely reduce the amount of blood testing we do without causing adverse events,” she said.
On Feb. 10, Health Canada advised manufacturers and suppliers that they must report blood collection tube shortages so the agency can “confirm the actual or potential shortage status of this device,” a doorman said. -word. The notification was triggered by Health Canada’s mandatory reporting of medical device shortages, introduced in 2020 in response to increased demand for medical devices during the pandemic, the statement said.
Marilyn Spagnoli, director of laboratory medicine and diagnostic imaging at Michael Garron Hospital, said in a statement that hospitals across North America are facing vacutainer supply issues, in part due to of the increase in the number of COVID patients leading to an increased demand for laboratory medicine and blood collection service.
She noted that while this is “a concerning challenge”, the hospital “is not currently experiencing any disruption in patient care services due to this shortage”. Spagnoli added that the hospital has contingency plans and efforts to conserve tubing and supplies are supported by Choosing Wisely Canada recommendations.
Unity Health’s Streutker agrees that the public should be aware of these critical shortages and said family physicians should also be aware of the issue “and be careful about ordering them.”
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