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Canadian Blood Services: the Road to Regaining Public Trust the Need for Blood Is Constant; So Is the Need for Donations

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Canadian Blood Services: the Road to Regaining Public Trust the Need for Blood Is Constant; So Is the Need for Donations Thought Leadership Canadian Blood Services: The road to regaining public trust The need for blood is constant; so is the need for donations. Every day, all the hospitals and clinics in Canada need blood and blood products to treat patients, since most surgical interventions and a great number of medical procedures require blood transfusions. This is where Canadian Blood Services comes in. Canadian Blood Services is a non-profit charitable organisation with a mission to manage the bloody supply for Canadians and provide a safe, secure, cost-effective and accessible supply of quality blood, blood products and their alternatives. We spoke with Canadian Blood Services’ CEO Dr Graham Sher at Research Features, to discuss this and more, in greater detail. n the 1980s, more than 2,000 people We recently caught up with Dr Sher at in Canada were infected with HIV and Research Features and talked with him about over 30,000 with hepatitis C after they the organisation’s role, his role as CEO over had been administered tainted blood the last 20 years and the future of blood products. In the wake of disaster, an donation in Canada. inquiry led by Justice Horace Krever exposed Iyears of negligence, bureaucratic inertia Can you tell us what attracted you to and at times corruption at the Canadian Red Canadian Blood Services and what your role Cross Society, then in charge of the blood there involves? donation system. In consequence of Krever’s When I was asked by the newly founded recommendations, 1998 saw the foundation Canadian Blood Services to join the of Canadian Blood Services that replaced organisation as a vice-president of medical, Canadian Red Cross Society in managing scientific and clinical management back in national blood supplies. It took nearly 20 1998, I worked as a physician and scientist on years of Canadian Blood Services’ leadership staff at the Toronto Hospital and on faculty and dedication to rebuild the Canadian blood at the University of Toronto. I had no plans system, make it an international success story, to leave my research lab or teaching role, and regain the public trust. but the opportunity to move beyond the individual patient level and have a greater impact on the wider health-care system, Patients depend and ultimately, serve more patients, was too on us to manage appealing to pass up. A few years later, in 2001, I became a a safe, secure and CEO. Since then, I have been leading the organisation through a multi-year cost-effective transformation journey aimed at redesigning blood system the entire service delivery model, 118 www.researchfeatures.com www.researchfeatures.com 119 Thought Leadership introducing best business practices, and Dr Graham Sher, CEO supplier of plasma and plasma protein Kidney Paired Donation (KPD) programme, to deal with the enormity of the grief of Canadian Blood growing a culture of high performance. Services since 2001 products for patients in Canada. we facilitate medically compatible kidney and loss they experienced was the most As part of transforming the national blood transplants through chains of donor remarkable display of humanity I had ever system, I have also led Canadian Blood We manage a pan-Canadian formulary of exchanges from medically incompatible witnessed. It was profoundly humbling Services through a significant expansion approximately 45 brands of plasma protein pairs. The Highly Sensitized Patient Kidney and entirely remarkable, in ways that defy in its scope of services, which led to the products, which we bulk-purchase on (HSP) programme improves chances of a description. Their impact on me personally organisation assuming a national leadership behalf of provincial governments. For the kidney transplant for hard-to-match patients. was so significant, that I switched paths and and coordinating role for both organ and patient’s standpoint, our product selection The National Organ Waitlist (NOW) is a dedicated my future career to haematology tissue donation and transplantation in process supports patients’ and physicians’ real-time data source for non-renal patients rather than neurology. And, as they say, the Canada, and the development of Canada’s involvement in decision-making. It’s also throughout Canada. rest is history! national cord blood banking programme. cost-effective. Bulk-buying and price Finally, I co-founded and continue to actively negotiations bring significant savings. We work with stakeholders, partners and What challenges are likely to face blood and participate in an international alliance of physician groups to evolve knowledge, organ service provision in Canada during national blood system operators, with the In addition to collecting plasma for policy and technology. This leads to the next decade? focus of benchmarking, best practice sharing transfusion, we collect plasma to be used as increased donation and transplantation We need to increase the amount of plasma and global policy advancement in our sector. a raw material to produce immune globulin rates, gives patients the best possible we collect to ensure a secure supply of (Ig), a critical, lifesaving drug in very high chances to receive transplants with plasma needed to manufacture immune Can you give us an overview of what demand. It is our responsibility to ensure optimal outcomes, and gives families the globulin (Ig), a critical lifesaving drug, for Canadian Blood Services does and what its enough plasma goes to manufacturing Ig for opportunity to honour their loved one’s Canadian patients. We plan to do this within aims are? Canadian patients. wishes to become an organ donor. our current voluntary, unpaid system. Canadian Blood Services manages the We also need to recruit more blood national supply of blood, blood products, We currently only collect enough plasma With more than 800 transplants resulting and organ donors. We are focused stem cells and related services for all to meet about 17% of the demand for Ig. from the KPD and HSP programmes on connecting with an ever-changing provinces and territories (except Quebec). To meet patient needs, we purchase the combined, many Canadians have received population of donors; the population in We operate within the larger health-care remainder of the necessary product from transplants that may never have otherwise Canada is shifting to metropolitan areas, system of transfusion and transplantation the commercial plasma industry. We plan occurred. and we need to go where the people go to medicine in Canada. Patients depend on to expand plasma collections in Canada to operate as efficiently as possible and make us to manage a safe, secure, and cost- ensure a secure supply of plasma for Ig for You are a haematologist by training, and an blood donation as convenient as possible for effective blood system. The organisation Canadian patients. expert in transfusion medicine. How did you donors. collects, tests and manufactures blood, first become interested in this field? blood products and stem cells, and plays an Can you tell us more about the OneMatch In short, while doing my undergraduate • For more information on the Canadian integral role in organ and tissue donation Stem Cell and Marrow Network? medical training, I was interested in Blood Services, their ground-breaking and transplantation. Fewer than 25% of patients who need stem neurology, and therefore, destined to research and blood donation, please visit cell transplants find a compatible donor in become a neurologist. I even did a PhD their website at blood.ca/en. Our responsibilities also include: running We draw in experts from various their own family. The rest rely on those who degree (simultaneous with my medical national patient registries for organ have volunteered to donate stem cells to degree) in neuroscience. In my second- donation and transplantation; operating the disciplines who together can bring anyone in need. Thanks to the OneMatch to-last year of medical training, while OneMatch Stem Cell and Marrow Network, programme we can now search more than rotating through a general medical unit, I which matches donors to patients that innovative thinking to bear on real 23 million donors in more than 70 registries become the responsible physician looking require stem cells transplants; as well as in other countries when we need to find after a young patient with acute myeloid Canadian Blood Services’ Cord Blood Bank. problems a match. By making donor data available leukaemia. We managed to get the patient worldwide, international registries have into remission, and ready her for a lifesaving Contact Moreover, Canadian Blood Services is trusted with a mission to ensure such a Today, whether patients are in Victoria, significantly increased the odds of finding a bone marrow transplant from her only Dr Graham Sher involved in research and development disaster would never happen again. Iqaluit, St. John’s, or anywhere in between, matching donor for any patient anywhere in sibling, an older brother. Canadian Blood Services efforts focused on several areas of they can count on the same high-quality the world. 1800 Alta Vista Drive transfusion and transplantation science Back in 1998, we inherited a fragmented product when they need it, without Back then, unrelated bone marrow stem Ottawa and medicine. We draw in experts from blood supply system plagued with critical geographical or financial barriers. When What role does Canadian Blood Services cell transplants had not become standard Ontario various disciplines who together can bring quality failures, badly ageing facilities, new pathogens emerge, like West Nile have in improving the national levels of of care, and so it was a related transplant or K1G 4J5 innovative thinking to bear on real problems. and structural complexity. When I became virus, SARS, H1N1, or Zika, Canadian Blood blood and organ donation? nothing. Fortunately, this patient’s brother Canada CEO, I recognised that to transform the Services is at the forefront of an international Improving the national inventory of blood was a perfect “6 out of 6” match for her, Why was the decision made to centralise system in a long-term and sustainable community of scientists working together is ongoing.
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