A colleague from the Pacific Northwest reports that their medium sized blood center, which collects around 35,000 whole blood units each year, is exploring the practicality of utilizing three-bed mini-coaches for mobile blood collection operations. Presently, they conduct mobile operations from full sized, four bed coaches. Their mobile operations account for about 70% of their collections. Their blood center covers a very large geographic region, including several "spread out smaller rural communities". It is not uncommon for their drive times to reportedly exceed two hours each way. They also conduct a fair amount of lower quantity collection blood drives in their immediate vicinity. They wonder if other centers would be willing to share experiences with using mini-coach type of vehicles for mobile collections. They seek information regarding cost effectiveness and impact on efficiency of operations.

The following comments have been received.

ADDENDA Mar. 19, 2006

1. Editor's note: Colleagues might find the information posted at the following links to be germane to the present discussion:

• News and Press Releases: Community Blood Bank Welcomes Second Mobile Coach 10/25/2004 (Community Blood Bank of the Lancaster County Medical Society, Lincoln, NE)
• Community Blood Bank of the Lancaster County Medical Society Newsletter, Winter 2004

ADDENDA Mar. 31, 2006

2. A transfusion medicine physician in Pennsylvainia comments that his blood collection center has a pair of 3-bed mini-coaches that they use for mobile collections. They use the mini-coaches for blood drives that are scheduled for 20 units or less. When they deploy the mini-coaches, they try to schedule two consecutive drives, one immediately following the other. They assign two staff employees to each vehicle, and these individuals work a 12-hour shift. Their recruiters have the responsibility to assure that enough donors are scheduled for a 12 hour shift. It has been their experience that their approach is cost effective if they can collect at least 13 units each day a mini-coach is used. Although they have not done it yet, they are considering deploying their mini-coaches to be able to collect 'double' red blood cell units on future mobile drives. Finally, because of the small size compared to a full sized coach, they report being able to access collection sites that are otherwise unaccessible with a larger vehicle.

3. A transfusion medicine physician in Spain reports that his center does not own a furnished coach for mobile collections. They set up for their mobile collections from scratch each time. He hopes his center will buy a coach in the near future, and if the cost is not too extreme, he would prefer that they buy "something big". One of the reasons for wanting to buy a big coach is his perception that the use of a larger coach will help to minimize the wait time for donations. He acknowledges that long waits can occur either at fixed sites or in mobile units, but he thinks that such delays are less likely when using bigger coaches. He believes that there are two major bottlenecks in the donation process: donor interview and the actual collection. He is concerned that smaller coaches can be easily clogged, especially if a donor should suffer an adverse event (i.e. passes out), or if a donor phlebotomy is slow, exceeding 12 minutes. Alternatively, there may be lack of bench space to accomodate individuals who have completed their donations and who need to be observed before being excused to go.

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Ira A. Shulman, MD
CBBS e-Network Forum Editor & Moderator