Optimizing O-negative RBC Utilization: Methods & Impacts from a Hospital Blood Bank and National Blood Supplier

Proposed Session Description: A shifting donor landscape and rising hospital demand have created a challenging chronic shortfall of O-negative red blood cells (ONRBCs). Hospital blood banks and blood suppliers must work collaboratively to optimize utilization, and we present some perspectives from each.

Since the start of the COVID19 Pandemic, a large academic medical center has engaged in internal quality improvement efforts to reduce inappropriate out-of-group ONRBC transfusions, defined as the use of an ONRBC for a patient with a blood type other than O-negative where a safe alternative compatible RBC product was possible. Recently, this has included retrospective auditing of each out-of-group transfusion; organization of events into categories; and modifications of policy, workflows, and inventory based on these findings. This process resulted in a significant decrease in the rate of out-of-group ONRBC transfusions and impact analysis can be performed on each isolated practice modification.

In concert, an initiative to strengthen Group O RBCs supply resiliency was developed and deployed in 2025 by a national blood supplier. This initiative focused on targeted hospital outreach, education, and practical tools to advance sustainable type O RBC stewardship. In conjunction with this initiative, Inventory Planning Schedules (IPS) were updated and use of ONRBCs for antigen negative orders were reduced, all while maintaining strong hospital confidence in red cell availability. One year after launch, the initiative has seen high hospital engagement, a measurable decrease in ONRBC distributions, and significant stabilization of O blood inventory.

This session will highlight key strategies, lessons learned, and evidence based practices to support responsible Group O RBC management. The session will address issues representative of a variety of practice settings ranging from a community setting to an academic center and participants will be able to apply strategies best suited to their environment.