This Saturday, at 2 pm, I was where you can find me pretty much every eight weeks at that time: at the Walnut Grove Lutheran Church attending the only mobile blood donor clinic held in North Langley. I have attended this clinic almost every time it has been run since it opened in the early 2000’s. Over that time I have seen a lot of changes and recently I have come to wonder what is wrong with the people who run Canadian Blood Services (CBS). Today I watched as donor after donor gave up on the clinic and walked out without donating, this according to the radio ads, during a blood shortage? While I was giving my donation I asked my phlebotomist a few questions and was disappointed with the responses. One thing she did make clear is that the only way things will change is if people speak out, so today I am going to do just that and speak out about the deterioration of services I have seen in the last 15 years giving blood at this clinic.
Let’s start with the good news. The people you encounter at the blood donor clinic are the best. They are always cheerful; they are quick to smile; and are ready to answer any questions. The major problem is that there simply aren’t enough of them. When this clinic opened they used to have eight donation beds and a couple recovery beds. Well in those 15 years this part of Langley has seen explosive growth with the population almost doubling. Given that growth you would expect to have seen a commensurate increase in the number of clinics or the capacity of the existing clinic? Well you would be mistaken. Instead we have seen the exact opposite. In a community that has nearly doubled in population they have held the number of clinics stable and have decreased the number of treatment beds by two (down to six beds). Instead of growing to meet our community’s growth the Canadian Blood Services have decreased our ability to donate by 25%.
All this week I have been hearing ads on the radio informing us that with the storm in eastern Canada there is a national blood shortage. The ads encouraged people to make appointments to donate. Given that information do you think that the CBS expanded its capacity at our clinic? Of course they didn’t. It had exactly the same number of beds as they always do, only this time around they didn’t have the staff to cover the limited number of beds they had available. When I arrived the sign was up informing us that they were down two staff members and that we should expect longer than normal waits. I would have been surprised except this is pretty much always the case with our clinic. I cannot remember a recent clinic where they weren’t at least one nurse/phlebotomist short.
So what does being two staff members short mean? Well during flu season (when lots of people don’t show up) you can often get through the entire donation process completed in under an hour and fifteen minutes. The fastest I’ve gone through is in 45 minutes (but I am a fast bleeder). Today, we sat for almost an hour and a half before we even got to see the first nurse, which brings us to the next problem: streamlining.
Over the last several years the CBS has been “streamlining” the blood donation process. They have automated the questionnaire and no longer require you to fill in the multiple choice exam before you see the nurse. In the process they have made it less efficient for the donor. Apparently, the streamlining is for CBS staff only and not for the donor. Instead I have seen a slower donation process that discourages donors in an era when they should be being as sensitive to keeping as many donors as they can. So what are they doing wrong? Let’s start with the most obvious flaw: hemoglobin testing.
For those not familiar with the process, before you can donate they have to ensure you have enough hemoglobin to donate. Women often have issues with their hemoglobin levels and don’t even know it. In her life my wife has been rejected for low hemoglobin more times than she has been able to donate. Under the old process they tested you for hemoglobin as the first step in the process right after you registered. Then if you failed you wouldn’t have wasted your afternoon, you’d be in and out in under 10 minutes. Well under the new “streamlined” process the donor does all their interactions with the nurse at the same time which means that today it would have taken my wife almost 90 minutes to have her hemoglobin tested to discover that she couldn’t donate. What brain surgeon thought this idea up? Being rejected for donation is bad enough but wasting an hour and a half sitting in a building with no WiFi, no music and no magazines only to be rejected is just ridiculous.
Going back to hemoglobin levels, as a result of a small proportion of women regularly failing their hemoglobin tests the CBS has changed the rate at which all women can give blood. Now women can only give blood every 12 weeks instead of every 8 weeks. Even worse if you are a young woman (under 24) it is something like every 104 days. My mother-in-law has given blood every 8 weeks for the last decade and has no trouble meeting the hemoglobin levels but she, too, is now cut off. My wife who can have low hemoglobin even if she isn’t giving blood and is just as likely to fail every 104 days. Telling my mother-in-law that she can’t give blood because her daughter has trouble with hemoglobin makes absolutely no sense. Instead of treating women as individuals they treat them like a single group and base their cut-offs on the smallest and weakest of their kind. Why not simply continue as we have by testing hemoglobin and letting those with adequate hemoglobin donate when possible?
As for the waiting process, the CBS does nothing to help us out there either with no WiFi, no music and no magazines. Yes, rather than springing for a WiFi hub for donors CBS doesn’t provide WiFi and for reasons unknown they have eliminated the music and magazines. For years I would bring my used magazines (Discover and Science because I’m a nerd) to donate to the clinics. The clinics collected and shared the magazines so if they did have delays you weren’t stuck being bored. Well sometime in the last 3 years they decided to stop collecting or distributing magazines and turned off the music that the phlebotomists used to play in the background to improve the mood. I can still remember listening to an afternoon playoff game being played at a clinic to encourage folk to come in during the playoffs. Once again convenience to the organization takes preference over improving the donor’s experience.
So let’s summarize, during a purported blood shortage CBS didn’t expand their clinic to encourage walk-ins.They allowed themselves to open short-staffed so those with appointments ended up spending over twice as long as normal to donate without any distractions to keep us happy. That being said this clinic never seems to have the staff necessary to allow for a reasonable donor experience. This the only clinic in a growing full of potential donors. Is it any wonder that the gent in front of me, a man I have seen for over 10 years at this clinic who has donated over 100 whole blood donations, stormed out vowing never to come back. This is exactly the type of donor they should cherish since repeat donors provide the vast majority of blood donations and they effectively blew him off. Meanwhile the young woman before me, making her first donation, wasn’t celebrated once she had donated because the clinic had one, yes that is right, they had one volunteer. My mother was a volunteer during the Red Cross days and historically they had a half-dozen volunteers to help out, keep people happy and celebrate the achievements of the young and repeat donors. Now, thanks to the bureaucracy that is the CBS, our clinic can only field one volunteer for the entire clinic.
If Canadian Blood Services’ plan is to alienate their core donor population while making the first-time donors wonder if this is how blood donations always go then bravo they have accomplished their task. If, on the other hand, their intention is to encourage new donors while making old donors feel special then they have failed miserably. Someone has to get the executives in charge of CBS to attend these clinics to see how frustrating it can be to donate blood outside of the Vancouver core. Remember, the vast majority of growth in the Lower Mainland has been outside of the Vancouver core but you couldn’t tell that from the way CBS runs its clinics. Growing communities like Langley are not seeing the level of service you would expect from an organization that depends on people coming in voluntarily to donate. They provide too few beds and then don’t schedule enough staff to cover the meager number of beds they do provide. The most recent change by CBS is supposed to provide a streamlining of the donation process. This streamlining may have been a success behind the scenes but it has made the actual act of donating blood more complicated, less convenient and frankly less appealing. When your entire business model depends on people happily coming in to donate then shouldn’t making them feel welcome and making the donation experience fast and easy be a priority? If so then the CBS has failed the people of Langley and in doing so are failing the people of British Columbia.