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

VI. Key Observations and Recommendations

Key Observations

The following is a list of key observations flowing from the evaluation findings, presented in order of priority.

1. Strategic positioning of the BSCP within government priorities should be considered.  The program may enjoy greater support if the Canadian government truly understood what was being accomplished. It will be important that BSCP accomplishments be communicated and promoted more heavily and consistently within the federal government.
2. The BSCP requires dynamic upper level leadership with a strong background in blood safety and/or a keen interest in and capacity to develop blood safety expertise who can set a bold future course for the program, raise the program’s profile, and leverage opportunities within Canada and internationally;
3. Canada should take advantage of the worldwide respect for the BSCP to raise the country’s profile in the international blood safety community. Fully leveraging this opportunity may require targeted resources, conscious strategic planning and positioning, as well as strong responsive leadership with experience and profile in the hemovigilance field. PHAC will need to identify a strong, knowledgeable spokesperson for the BSCP whose responsibility it is to represent Canada effectively and consistently in international forums and provide advice and support to other countries as requested.
4. A review of the contribution project approval process within PHAC should be undertaken to address the inefficiencies that have been experienced by staff and recipients.  This should include a review of procedural requirements within PHAC to mitigate unnecessary bureaucracy, in line with the recommendations resulting from the Blue Ribbon Panel.  In addition, PHAC should review whether contribution funding is the most appropriate method where long-term funding is required to maintain the surveillance systems once they have been established.

Recommendations

The following is a list of recommendations flowing from the evaluation findings, presented in order of priority. Some of the recommendations listed may have resource implications (i.e., may require additional resources beyond those currently budgeted for BSCP), however, specific cost implications cannot be estimated at this point. Further investigation and consideration will be required.

1. Greater effort could be made to emphasize and promote the link between ‘blood safety’ and ‘patient safety’, to underscore and refresh the consistency of the BSCP with broader government and department priorities that are currently receiving significant attention.
2. A Strategic Human Resource Plan should be developed and implemented by PHAC over the next twelve months, taking into account the current and future needs of the program to support achievement of its full potential. This may include focussing on the identification and recruitment of:
   • In-house expertise in blood safety and/or transfusion medicine (particularly among epidemiologists);
   • In-house IT expertise;
   • In-house statisticians (particularly those capable of sophisticated modelling) who will be able to make the most of the existing data, and improve the timeliness of analysis and reporting; and
   • General support staff to reduce delays in agreement processing, funding, reporting, etc. It is acknowledged that implementation of this recommendation may have resource implications; however, specific cost implications cannot be estimated at this point. Further investigation and consideration will be required.
3. Continue establishing and improving upon existing BSCP components:
   • For TTISS: ensure adequate participation of the provinces and territories, and work towards more timely reporting. Continue to improve data quality. Conduct analyses to enable risk identification for high risk populations.
   • For TESS: ensure adequate national representation among participating hospitals (particularly small hospitals), and ensure timely reporting. Also, consider further streamlining of the error coding system to promote simplicity and enhance data quality.
   • For CTOSS: this system still needs to be developed, piloted, refined, and implemented across the country. The feasibility of developing and implementing CTOSS, even if done incrementally, within the current allocated budget should be critically reviewed. Next steps (e.g., reallocating BSCP budget, request for additional funding) should be considered as appropriate. 
   • For public health linkages: these need to be fostered more consistently in the provinces and territories, as well as at the national level.
   • For the blood sample archive: agreements need to be reached about confidentiality and testing, so that testing can be carried out and results reported.