Our Blood Service ANNUAL REPORT 2012
Finnish Red Cross Blood Service Part of the Finnish health care system THE FINNISH Red Cross Blood Service (FRCBS) is a financially and operationally independent unit within the Finnish Red Cross. It is a centralised organisation providing nationwide blood services in Finland. Its tasks include organising blood donor sessions and collecting blood as well as the testing of donated blood, the production of blood components and the distribution of blood components to hospitals. The FRCBS provides the health care sector with red cell serology testing, and the testing of organ, tissue and stem cell transplants, clotting factors and thrombocytes. In Finland, the blood group of all pregnant women is determined and their blood is screened for blood group antibodies by the FRCBS. The FRCBS also maintains the Finnish Bone Marrow Donor Registry, the Cord Blood Bank and Bone Bank Network. The strong expertise of the FRCBS is built on in-house research and development, forming the foundation of safe and reliable blood transfusions now and in the future. The FRCBS employs about 600 people in 17 locations. In addition, the FRCBS employs part-time staff and employees that are called to work when necessary. Most of these staff work at the Helsinki Blood Centre in Kivihaka, which houses several departments, including all laboratory services. EDITED by FRCBS Communications and Mediafocus Oy TEXTS by Willy Toiviainen, Tiia Soininen and Päivi Hurttia GRAPHIC DESIGN by Mia Noronkoski PHOTOGRAPHY by Jari Härkönen, Antti Kurola, Ari Nakari, Jussi Vierimaa and FRCBS ILLUSTRATIONS by Lassi Kaikkonen TRANSLATED by Meditrans Oy and FRCBS Communication PRINTED by Libris Oy 2 BLOOD SERVICE ANNUAL REPORT 2012
Contents ::::::::::::::::::::::::::::::::::::: COLLABORATION BETWEEN PROFESSIONALS...4 We are creating the potential for saving life. BLOOD PRODUCTS DESIGNED FOR THOSE IN NEED...6 It is the duty of the Blood Service to support hospitals in ensuring OPERATION-SPECIFIC REVIEWS...8 HOSTING HUNDREDS OF PROFESSIONALS...14 BLOOD SERVICE MANAGEMENT SYSTEM...16 The Blood Service is a part of the Finnish Red Cross. SUSTAINABILITY REPORTING MEASURES...17 BLOOD SERVICE FINANCES...18 from its operations to cover its costs. VALUES...19 the guidelines of the Blood Service. Blood products are given to over 50,000 patients annually Over 100 allogenic stem cell transplants (involving cells from another person) are performed annually in Finland. 1,000 bags of blood are donated in Finland. There were over 250,000 blood donations in 2012. Up to 12% Marrow Donor Registry has over 20,000 members. By giving and concrete manner. BLOOD SERVICE ANNUAL REPORT 2012 3
Collaboration between professionals ::::::::::::::::::::::: an important role in the chain of helpers. We are working to achieve a common goal. We are creating the potential for saving life. BLOOD DONATION We organise all blood donations throughout Finland. Each working day, we offer some 1,000 blood donors a satisfying opportunity to help. We offer new opportunities to join the chain of helpers and we develop electronic tools to facilitate contacts. BLOOD PRODUCTS We manufacture safe blood products for patients and distribute products changes and provide high-quality services for hospitals to support them in blood transfusions. LABORATORY SERVICES We test the donated blood for safety and blood group properties. We provide a range of clinical laboratory tests for hospitals. We perform the tissue typing for all organ transplantations and stem cell transplantations performed in Finland and also carry out the blood group tests for pregnant Finnish women. We work on a 24/7 basis and are strongly committed to developing the electronic transmission of laboratory test results. PHARMACEUTICAL DISTRIBUTION We distribute medicinal products manufactured by our partners to hospitals and private pharmacies on a 24/7 basis. We prepare for the distribution of new individualised cell therapy products by developing CELL AND TISSUE THERAPIES We search out compatible blood stem cell transplants for patients and handle their distribution. We also process cells and develop novel cell therapies together with clinicians. Our new cell production centre permits the manufacture of cell therapies to treat severe illnesses. RESEARCH AND PRODUCT DEVELOPMENT We investigate blood and stem cell properties and create new opportunities for developing blood transfusions and cell therapies. Our future research and development projects will focus on the effectiveness and safety of blood service operations and organ and tissue transplantations as well as safe and effective cell therapy products. 4 BLOOD SERVICE ANNUAL REPORT 2012
:::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: MEDICAL EXPERT AND EDUCATION SERVICES performing blood transfusions and cell therapies. We systematically and actively train physicians and nurses participating in blood transfusions. QUALITY MANAGEMENT AND OPERATIONAL SYSTEMS We ensure high quality in all our activities and make sure that the requirements for accreditation are met and that our activities comply INFORMATION MANAGEMENT We develop reliable electronic services for clients and donors. We use our information systems in an intelligent way to organise activities and analyse our operating environment. FINANCES AND PURCHASING and purchase the materials and services we provides a secure basis for future activities. COMMUNICATIONS Using various channels, we proactively provide information about our activities to donors, clients, our personnel, partners and everyone interested in blood services. We encourage donors to join the chain of helpers. LOGISTICS We ensure the smooth, reliable transportation of donated blood, donor samples and products both internally and between the Blood Service and hospitals. that minimises costs. HUMAN RESOURCES SERVICES We take good care of our personnel and systematically strive to enhance their professional skills and job satisfaction levels. We want to ensure that the Blood Service is an attractive and interesting place to work in the future, too. BLOOD SERVICE ANNUAL REPORT 2012
Blood products designed for those in need ::::::::::::: IN EUROPE, about 40 to 45 bags of red blood cells are required annually per 1,000 inhabitants. The number varies from country to country and there is also considerable regional variation within countries. Factors influencing the number of blood transfusions include developing treatment practices and the population s age structure and care needs. The age groups in which the need for blood transfusions is proportionally highest are newborn babies and adults over 70. The changing age structure of the Finnish population poses many challenges for society. One of the effects is the increase in demand for healthcare services. The Blood Service is prepared for a situation in which Senior Management Team at the end of 2012: MARTTI SYRJÄLÄ SATU NYSTRÖM Human Resources Director HEIKKI MYLLYNIEMI Information Management Director SUSANNA HUUSKONEN Financial Director TOM KRUSIUS Medical Director KARI ARANKO Product Development EEVA NYBERG-OKSANEN Systems SATU PASTILA MARJA SIHVOLA 6 BLOOD SERVICE ANNUAL REPORT 2012
::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: the growing proportion of elderly people raises the need for blood products. We also look for ways to ensure there are always sufficient donors in the future since, as the population grows older, the proportion of those of donation age will decrease. It is the duty of the Blood Service to support hospitals in ensuring that donated blood provides the maximum possible ben- efits for patients. We actively inform Finnish physicians about the results of our own research activities and about international developments. Cooperation with hospitals has yielded excellent results, and the use of blood products in different conditions has been made more uniform. At the same time, advances in surgery have led to better management of bleeding during operations. The harmonisation of blood product use and advances in surgery have made it easier to manage the need for blood. While we expected an increase in product use, this has not been the case. In 2012, the need for red blood cells decreased by 5% and that for platelets by 4% compared with the previous year. This is a most encouraging trend at national level and ensures that sufficient blood is available for all who need it. For us at the Blood Service, it means that we must adapt our operations to meet these needs. Voluntary blood donors form the basis for blood service activities. In the past year, 144,000 blood donors visited blood service centres and blood donation events and made a total of 251,000 donations. I wish to present our heartfelt thanks to all donors and to our skilled and committed personnel for participating in the chain of helping. Martti Syrjälä Chief Executive of the Blood Service ANNUAL REPORT 2012 7
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Blood Products Blood product sales to hospitals, 2010 2012 IMPROVEMENTS IN BLOOD PRODUCT MANUFACTURE THE USE of blood products in Finnish hospitals decreased markedly in 2012. The Blood Service reacted to this change by reducing its blood collection capacity and revising the manufa cturing process. New technology was adopted in the manufa c- ture of blood products. New automatic blood separators replaced the previous ones acquired ten years ago, which fur - ther improved the speed and reliability of operations. The blood bag system was also replaced by the one best suited fo r the new equipment. Customer service was improved, including the introduction of a new telephone system. hours being Mon Fri 8 am to 5 pm), i.e. in the evenings and weekends Preparation To tal Distribution outside Proportion supplied such as smaller products for children and washed and irradiated cells. Donated whole blood utilisation for blood products in 2012 Removals related to laboratory results * Some expired red blood cells are used as raw material for manufacturing medicines ** Proportior ns of the whole blood used for platelet product manufacture BLOOD SERVICE ANNUAL REPORT 2012 9
Blood Donation IMPROVED OPPORTUNITIES FOR BLOOD DONATION THROUGHOUT the year, there were enough blood donors to meet patients needs. The blood donation network was developed by improving donation opportunities in areas with a large population of donation age and where the young population is expected to grow. We opened a new blood service centre in Espoo and increased the number of blood donation events in Ostrobothnia. Collaboration with companies took on a completely new look as the new BloodGroup model was successfull y launched in October. Blood donor groups from as many as 219 companies and organisations had joined by the end of the year 2012. Blood group distribution among Finns New blood donors in 2012 A+ A- B+ B- AB+ AB- O+ O- Whole blood donations, 2003 2012 2003 2004 2006 2007 2008 2009 2010 2011 2012 Blood servic e in infection tests, 2008 2012 2008 2009 2010 2011 2012 Hepatitis B 6 3 4 1 2 HIV 3 1 3 0 1 * *The test was changed in February 2012. The new syphilis bacterium antibody test Whole blood donations, 2012 Donation events centres collected therefore varies from year to year. (aphereses) are also made annually. Blood donors age and gender distribution in 2012 Male Female 0 10 BLOOD SERVICE ANNUAL REPORT 2012
Laboratory Services Blood Servic e laboratory tests for healthcare units 2011 2012 THE LABORATORY STARTED PROCESSING BIOBANK SPECIMENS WE PROVIDE clinical laboratory tests for patient care as needed by hospitals. In 2012, demanding red blood cell antibody identification assays were an area of particular growth. The Blood Service is a national refer ence laboratory fo r blood group assays. Laboratory activities were developed, among others, by enhancing round-the-clock operations, adopting new technologies in donor virus assays and introducing genotyping in donor blood group assays. The Finnish Haematology Register and Biobank is a national research project concerning the registration, diagnosis and treatment of haematological conditions. The required specimens are processed in a centralised manner at the Blood Service. In 2012, the Blood Service processed a total of 161 re- search specimens intended for the Haematology Biobank in its patient assays. Blood compatibility tests perf ormed Pharmaceutical Distribution INCORPORATING CELL THERAPY PRODUCTS INTO THE PHARMACEUTICAL DISTRIBUTION SYSTEM THE BLOOD SERVICE continued its pharmaceutical supply operations through new plasma supply and product distribution agreements. In future, we will submit 8-hour plasma (to be frozen within 8 hours of donation) to Octapharma and 24-hour plasma to Baxter. The Blood Service has a pharmaceutical distribution agreement with Octapharma. In 2012, the Blood Service prepared fo r the distribution of ChondroCelect in Finland. The product is intended fo r repairing knee cartilage damage and is the first cell therapy product to be granted a marketing authorisation in Europe. Supplies to Finnish clinics will start in 2013. BLOOD SERVICE ANNUAL REPORT 2012 11
Organ transplantations performed 2010 2011 2012 Heart 22 18 22 Total 262 274 299 The Blood Servic e perf orms tissue typing for all organ transplantations perf ormed in Finland. Cell and Tissue Therapies CELL PRODUCTION AS A NEW OPTION IN TISSUE SERVICES NEW MEMBERS were actively recruited to the Bone Marrow Donor Registry to replace those leaving it because of old age or other reasons. Thanks to successful campaigning, we were able to attract more than 1,333 new members to the 20,000-strong Registry. In the meantime, 614 members left. A new electronic registration service was launched to make registration easier. The Blood Service distributed a total of 128 blood stem cell grafts in Finland and abroad. Our own couriers distributed 54 stem cell grafts to Finnish patients. The first virus-specific T cell product was supplied from a foreign donor to a Finnish patient in autumn 2012. Virus-specific T lymphocyte grafts are needed when a virus activates in a blood stem cell graft recipient, the patient has no specific T cells (lymphocytes) for the virus in question and medication is insufficient. The Bone Marrow Donor Registry turned 20 in 2012. Our Registry was acclaimed by the WMDA (World Marrow Donor Association) as being one of the world s best bone marrow donor registries in terms of the effe ctiveness and speed of its registry activities and in terms of donor commitment. The Blood Service s new cell production centre was prepared for launch, and the authorities gave permission for the manufa cture of mesenchymal stroma cells to treat individual patients with refractory graft-versus-host rejection. The centre started cell manufa cturing operations for patient care in early 2013. Stem cell grafts supplied by the Bone Marrow Donor From a Finnish registry donor to a Finnish patient From a non-finnish registry donor to a Finnish patient From a Finnish registry donor to a non-finnish patient 2010 2011 2012 Bone marrow graft 31 41 22 Cord blood graft 9 6 11 Total 96 134 128 2010 2011 2012 Bone marrow graft 13 13 6 Cord blood graft 0 0 2 Total 20 26 26 2010 2011 2012 Cord blood graft 2 0 3 Lymphocyte graft 1 6 12 Total 66 98 93 2010 2011 2012 Bone marrow graft 1 1 1 Blood stem cell graft 1 3 2 Cord blood graft 7 6 6 Lymphocyte graft 1 0 0 Total 10 10 9 12 BLOOD SERVICE ANNUAL REPORT 2012
Research and Product Development NEW STRATEGIES FOR RESEARCH AND DEVELOPMENT Medical ACTIVE TRAINING FOR HOSPITAL PERSONNEL THE PHYSICIANS and experts of the Blood Service assist hospital personnel in carrying out blood transfusions and cell therapies safely and effectively. Medical services include advice, compiling reports and publications, blood safety reports, and educational material and events. In 2012, the Blood Service organised 10 days of training for its hospital clients attended by 350 persons. In addition to blood transfusions, the topics included the treatment of massive bleeding, blood group immunisations during pregnancy, blood group and antibody determinations and the treatment of cartilage damage with a cell therapy product. Blood Service experts also gave dozens of lectures at hospitals educational events to hundreds of participants. THE BLOOD SERVICE prepared a new research and development strategy for the period 2012 to 2014. Research and development activities will focus on 1) the effectiveness of blood service operations, 2) the safety and effectiveness of organ and tissue transplantations, and 3) safe and effective cell therapy products. In 2012, the Blood Service researchers contributed to a total of 47 publications. Half of these were made in collaboration with Finnish university hospitals. Significant research findings included the properties of mesenchymal stem cells, markers required for cell identification, and correlations between blood groups and intestinal microbiota. Our experts on tissue compatibility and laboratory tests actively participated in international research and development projects concerning HLA tissue typing and in projects related to the viral and microbial quality of blood products. The Blood Service s research and development projects received more than 600,000 of external funding. The most important sources of funding were the Intelligent Monitoring programme by Salwe Oy funded by Tekes (the Finnish Funding Agency for Technology and Innovation), in which the Blood Service researches and develops applications for the monitoring of stem cell functionality and intestinal inflammations, and special government subsidies which were particularly used to fund research into therapeutic cells and blood, tissue and organ transplantations. BLOOD SERVICE ANNUAL REPORT 2012 13
Hosting hundreds of professionals :::::::::::::::::::::::::::: THE BLOOD SERVICE is a varied workplace in which employees carry out extremely important tasks together with experts from a range of fields. In 2012, the Blood Service had an average of 631 employees, whose contributions total the equivalent of 545 full-time employees (FTE). Human Resources development focused on adopting new electronic office and communications systems, LEAN projects to enhance processes, supervisor training and business intelligence tools. To promote the development of supervisory work, 360-degree supervisor assessments were carried out across the organisation. Absences due to sickness have decreased considerably over the past few years. There was a slight increase in short-term sickness absences in autumn 2012, but on the whole, absenteeism is low. The Blood Service has continued with a systematic dedicated well-being programme that focuses on different areas of well-being at work, such as expertise, well-functioning working communities, supervision and management as well as health and work fitness. The work fitness of personnel is maintained through sports activities, various campaigns, personal support and extensive occupational health care services. 14 BLOOD SERVICE ANNUAL REPORT 2012
::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: Number of personnel, 2012 Temporary 62 On-call 39 Number of personnel, full-time (FTE), average 545 All absences due to sickness and accidents, days per person 1.80 1.60 1.40 1.20 1.00 0.80 0.60 0.40 Distribution of personnel within the 0.20 0.00 jan. feb. mar. apr. may june july aug. sep. oct. nov. dec. Sickness absences 2010 Sickness absences 2011 Sickness absences 2012 BLOOD SERVICE ANNUAL REPORT 2012
Blood Service management system ::::::::::::::::::::::: THE ACTIVITIES of the Finnish Red Cross (FRC) Blood Service are based on the Blood Service Act (197/2005) and the Blood Service Decree (258/2006). Blood services are supervised by the Finnish Medicines Agency Fimea, under the Ministry of Social Affairs and Health. The Blood Service is a financially and operationally independent organisation belonging to the Finnish Red Cross. In between the FRC general assemblies and council meetings, the highest authority in matters regarding the Blood Service is vested in the Board of the FRC, which is also responsible for the activities and financial matters of the Blood Service. The Board of the FRC appoints the Board of the Blood Service. The duties of the Board of the Blood Service include strategic planning and supervising the safety and effectiveness of operations. The Board of the Blood Service comprises a chairperson, a deputy chairperson and four additional members. Together, they represent multidisciplinary expertise within the areas of the Blood Service s activities. The Secretary General of the FRC is entitled to attend and speak at Board meetings. The Chief Executive of the Blood Service is in charge of the operations of the Blood Service and their further development. The Senior Management Team supports him in his duties. Blood Service, organization 1.1.2013 Medical Expertise Blood Donation Chief Executive Blood Human Resourcess Communications Development Information Management Services BOARD OF THE BLOOD SERVICE AT THE END OF 2012: From left: Gunvor Kronman, Tuula Oksanen, Kai Parkkola. 16 BLOOD SERVICE
Sustainability reporting r measures ::::::::::::::::::: THIS TABLE presents key figures in accordance with the GRI (Global Reporting Initiative) guidelines. Indicators relating especially to blood service have also been included. 2012 2011 2010 3 CO 2 CO 2 LA7 Occupational accidents and injuries 30 28 23 Personnel training (Euro/person) -468-948 -710 (** Buried waste also includes waste produced by the Helsinki Mobile Blood Servic es Unit. BLOOD SERVICE ANNUAL REPORT 2012 17
::::::::::::::::::::::::: Medicines 4.4 4.8-8 7 Unprocessed plasma 6.6 8.1-19 10 Other 0.9 1.0-10 1 Total 66.0 69.0-4 100 THE BLOOD SERVICE is a non-profit organisation that uses the proceeds from its operations to cover its costs. Activities are funded by income from hospitals for blood and other products used and for services supplied by the Blood Service. The Blood Service is not supported by government funds or other external sources, except for some grants and subsidies for research projects. In 2012, the Blood Service had a turnover of 66.0 million, a decrease of 4.4% on the previous year. Turnover declined in almost all operating areas except for tissue services. Blood product sales fell by almost 1 million and those of unprocessed plasma by 1.5 million. New treatment practices have allowed hospitals to reduce their use of blood products. The decrease in unprocessed plasma sales is explained by lower prices and the annual variation in supply schedules. At the end of the financial year, the Blood Service held deposits in the FRC s organisational bank totalling 14.0 million. At the end of Cost distribution, 2012 Cost of one bag of blood, 2012 2012, the balance sheet total of investable capital was 30.0 million. This has mostly been invested in a range of funds. The Blood Service prepares a profit and loss account and a balance sheet on its operations. In 2012, there was a deficit for the financial year of 0.8 million ( -2.3 million in 2011). The Blood Service s financial result is included in that of the Finnish Red Cross. 18 BLOOD SERVICE ANNUAL REPORT 2012
Values:::::::::::::::::::::::::::::::: OUR VALUES: HELPING A PATIENT IS A JOINT EFFORT Our business is to offer each patient the chance of a new and better life. In addition to the FRCBS staff, the care chain includes donors and hospital personnel and a host of volunteers who assist in organising blood donor sessions. WE ARE PROFESSIONALS The FRCBS employs about 600 professionals, all experts in their field. We use donated blood to make blood components that hospitals need in the treatment of patients. We also offer a range of laboratory and consultation services to hospitals. A NON-PROFIT ORGANISATION The FRCBS is an independent, non-profit unit of the Finnish Red Cross. Its expenses are covered by income from blood components, laboratory and tissue services and pharmaceuticals sold to hospitals. The FRCBS does not receive financial support from its parent organisation, nor are its activities subsidised by the Finnish government. BLOOD SERVICE ANNUAL REPORT 2012 19
Helsinki Blood Centre HELSINKI FI-00310 Helsinki Local Donor Centres ESPOO HELSINKI HÄMEENLINNA JOENSUU JYVÄSKYLÄ KOKKOLA KUOPIO LAHTI LAPPEENRANTA MIKKELI OULU PORI ROVANIEMI FI-96200 Rovaniemi SEINÄJOKI TAMPERE TURKU VAASA