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

IV. Summary of key findings

The following section provides a summary of the key findings for each evaluation question. Detailed responses to each of the evaluation questions can be found in Appendix A.

The BSCP’s purpose is still as relevant as ever. While the risks posed by known viral infections in Canada and other parts of North America and Europe have largely decreased, there is still the risk of other types of transfusion-transmitted infections, such as bacterial and parasitic infections. Likewise, there continues to be a risk of other errors, such as transfusing the wrong blood to the wrong patient. Hemovigilance has been in existence almost two decades, but there is still the need for improvement and change in order to improve patient and public safety.

According to stakeholders, there continue to be significant risks associated with transfusions and transplantations, and the federal government has a role to play in monitoring transfusion and transplant related errors and adverse events. There is also increasing interest in international cooperation around surveillance, especially in light of the increased mobility of blood, blood products, cells, tissues and organs across national borders.

There is broad agreement that the BSCP involves the appropriate target audiences and activities.

The stakeholder groups who are actively engaged in the program in some way can be considered target audiences. Based on the document review, these include: Health Canada; funding recipients; Federal/Provincial/Territorial public health authorities; public health practitioners; blood, blood products and CTOAR transplantation originators; academics; professional associations; and other key influencers in the public health environment. Most stakeholders believed that the BSCP’s target audiences are appropriate, if the goal is to improve the safety of transfusions and transplants. However, there may also be the potential to include some other target audiences.

The core activities of the BSCP are to provide funding, through contribution agreements, for provinces and territories; encourage linkages with public health; establish national tools and standards for surveillance; provide funding for research projects; coordinate standing committees and working groups; and coordinate ad-hoc committees. Most stakeholders believed that the BSCP’s activities were appropriate, if the goal is to improve the safety of transfusions and transplants. Again, there may also be the potential to expand on certain current activities and add additional activities.

The review of the PHAC Report on Plans and Priorities 2008/09, the PHAC Strategic Plan 2007-2012, the BSCP and TOSS logic model suggests that the BSCP program continues to be consistent with departmental and Government of Canada priorities. In addition, stakeholders felt that the program contributed to the current ‘patient safety’ mandate of government. Accordingly, there may be an opportunity to promote the link between blood safety and patient safety, to emphasize and refresh the consistency of the BSCP with broader government and department priorities that are currently receiving significant attention.

The implementation of the BSCP is a challenging undertaking considering the range of institutional, legal and organizational contexts where implementation needs to be carried out, the coordination needed and the many stakeholders involved. The main challenges have related to data quality (for TTISS and TESS), under-utilization of data, departmental bureaucracy, lack of consistent strategic leadership, under-resourcing of CTOSS, IT demands and the lack of recognition for BSCP accomplishments. Some of the more common opportunities identified were collaborative relationships, Canada’s role as a world leader, the potential for recognition and support within Canada, and the potential to apply learning from TTISS to CTOSS.

Many of these challenges and opportunities are interrelated and complex. For instance, to fulfill its international and national potential, comprehensive strategic visioning and in-house expertise may be required. As well, the presence of strong and consistent leadership may assist in these efforts, along with finding new solutions to challenges associated with the bureaucracy of the system in which the program must operate (e.g., the renewal of contribution agreements).