ARCHIVED - Summative Evaluation of the Blood Safety Contribution Program - Final Report

 

Appendix A: Detailed Key Findings

This section presents the key findings for each of the evaluation questions.

Impact of BSCP Contributions on Outcomes

valuation question 12: How have the contributions flowing to each of the funding recipients impacted the achievement of BSCP outcomes and contributed to national surveillance systems?

Particularly in complex systems, it is often difficult to determine the extent to which a given program contributed to its desired outcomes. There are typically many other factors that also have an influence on the same outcomes. For example, surveillance systems might have come into existence at the impetus of provincial and territorial governments, even if the federal government had not taken a leadership role through the BSCP. Likewise, it can be difficult to determine the extent to which the surveillance data increases capacity to identify and address emerging issues and risks associated with the use of blood, blood products or transplantation of cells, tissues and organs. Perhaps emerging risks would have been identified as quickly without the surveillance data, or perhaps not.

We have taken two approaches to estimate the likely impact of the BSCP contributions on desired outcomes. The first was to explore, for TTISS and TESS, whether surveillance capacity in the various provinces and territories seemed to be related to the provision of BSCP funding. The second was to obtain stakeholders’ perceptions about the extent to which the BSCP contributes to the outcomes.

Relationships between availability of funding and development of surveillance systems

Table 3 shows the relationship between the approval of TTISS funding and the development of surveillance systems for adverse events in the provinces and territories. As can be seen in the table, regions that were awarded the earliest funding were more likely to report that they had implemented their surveillance systems early on, while those who were awarded funding later also tended to implement their surveillance systems later.

These data have numerous limitations: the implementation dates of the surveillance systems were obtained through the survey and may not be accurate; in many regions, survey respondents contradicted one another, so a firm date could not be determined; and approved funding may not have been received right away. However, the findings suggest that involvement in the BSCP may have been instrumental in each of the regions developing their surveillance systems for adverse events.

Table 3: Fiscal year for which TTISS funding was first approved, and date at which surveillance system for adverse events was implemented, by province/territory
  Province/Territory
BC QC PE NS MB ON NB SK NT YK NL AB NU
aNote that this may have been different from when funding was first received
bWas not approved for funding in 04/05
cBased on estimates provided by survey respondents. In some regions, there were conflicting responses from respondents within the same region, or respondents were not able to provide an estimate (indicated by “n/a”).
Funding first approvedTable 3 - Footnote a 99/00 99/00 99/00 00/01 01/02 01/02 02/03 04/05 04/05 04/05 05/06 02/03Table 3 - Footnote b -
When surveillance system was implementedTable 3 - Footnote c Apr 2001 1999/ 2000 Mar 1999 n/a Jul 2003 n/a Jun 2003 Jan 2004 Mar 2004 n/a n/a Nov 2007 n/a

The survey also asked if the regions had established a surveillance system for transfusion-related errors. The four provinces/territories involved in TESS, plus two others, indicated that they had. The remaining five provinces/territories indicated that they had not. This again tentatively suggests that involvement in the BSCP contributed to the development of these systems.

Stakeholder Perceptions

More than half of the survey respondents (57%) indicated that they would not have implemented their surveillance system for transfusion-related adverse events without the BSCP/TTISS funding. The remaining 43% of survey respondents said they would have implemented the system without the funding, but over half of these indicated that they would not have done so as comprehensively or as quickly.

About one third (36%) of the survey respondents from the six provinces/territories that had implemented a surveillance system for transfusion-related errors said they would not have implemented it without the BSCP/TESS funding. The remaining two thirds said they would have implemented the system without the funding, but a third of these indicated that they would not have done so as comprehensively or as quickly.

As mentioned in an earlier section, the majority of stakeholders felt that it would be more difficult to identify, assess, and mitigate risks related to transfusion of blood and blood products without the TTISS and TESS data.

Summary

Stakeholder perceptions, combined with observed relationships between availability of funding and implementation of surveillance systems, suggest that the BSCP likely contributed to the development and implementation of surveillance systems for transfusion-related adverse events and errors. Although some regions might have developed these systems without the BSCP, this may not have happened as quickly or as comprehensively.

Stakeholders believed that it would be more difficult to identify, assess, and mitigate risks related to transfusion of blood and blood products without the TTISS and TESS data.

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