The case: Trk Kzlay (Turkish Red Crescent) is the largest blood-product supplier in the country. All blood collected by Kzlay is from volunteer donors. Approximately

0. The case:
   Türk Kızılayı (Turkish Red Crescent) is the largest blood-product supplier in the country. All blood collected by Kızılay is from volunteer donors. Approximately 95 percent of that blood is processed into components, including plasma, platelets red blood cells, and a variety of such plasma derivatives as albumin and clotting factors, which are distributed to hospitals for clinical use. Blood is collected at over 100’s of fixed and mobile sites throughout Turkey. Fixed locations sites are permanently established locations that are open during regular hours. Mobile sites are, in most cases, operations that are set up using portable, off-loaded equipment at a temporary site provided by a sponsor, such as a business, school or community group. Some mobile sites are operated using self-contained units, which are modified buses or trucks that contain all the beds and other equipment needed. In these cases, the blood drive is conducted inside the vehicle. At present, a considerable percentage of total blood collected is from mobile sites.

   Kızılay depends heavily on repeat donors. These donors give on a regular basis and form the mainstay of the donor pool. Because donors are volunteers, recruitment and retention are difficult. Kızılay is very interested in

1

keeping donors satisfied so that they will continue to give blood. Little can be done to alleviate the discomfort of being stuck with a needle, but donors have identified several other factors as major determinants of their level of satisfaction and significant influences on their decisions to return. These include the time they spend at the donation site and the time they spend waiting in line. Donation time is also important to blood drive sponsors, especially employers who give their employees time off to donate blood. When donation time is excessive, employ- ees are away from their jobs for an extended period, and this has a negative effect on the company’s productivity. Donors dissatisfied with the donation experience may not return. If a drive sponsor is dissatisfied, Kızılay may not be invited back, and a whole group of donors will be lost. Despite the fact that Kızılay tells donors and sponsors that donation time is about one hour, for many donors it takes one and-a-half to two hours.

Many factors contribute to donor-processing problems. One major factor is the absence in most cases of any type of appointment system. In effect, the arrival of donors at these blood drives is totally random. Because donor scheduling may be impractical in many cases, such as open community blood drives, and because there is a widely held belief among donor recruiters that imposing appointments will alienate donors, it is not likely that an effective scheduling system can be implemented soon.

Another factor that has increased the donation time and contributed to long waiting lines has been the increased awareness of diseases that may be transmitted by blood, specifically AIDS and hepatitis. This has affected the donation process in two ways. First, donor screening procedures have become more rigorous. Donors have to read more material, they must answer more health history questions, and they must complete a confidential self- exclusion step. Second, the threat of disease transmission has forced staff to take additional precautions when handling donors and their blood. They must use gloves, needle guards, and other devices and procedures to protect them from undue exposure to blood.

Even though donors and drive sponsors complain increasingly about the lines and time spent, the blood ser- vices regions have been able to dedicate few additional resources to solve the problems. Budgets are limited and there is a severe shortage of nurses throughout the country. Have at least three causes.