Blood banking services in critical access hospitals in Kansas: A laboratory perspective

Objectives: To investigate the resource capacity for blood banking in critical access hospitals (CAHs) in Kansas and the experiences of medical laboratory personnel working in them. Methods: An electronic survey was implemented to record data from all 82 CAHs in Kansas between May and July 2023. The distance between hospitals with no blood bank services and commercial blood banks was calculated. Results: Only 63.4% of Kansas CAHs located in nonmetropolitan counties reported access to 24/7 blood bank services. In 12.2% of laboratories with 5 or fewer workers, there were no staff proficient in blood bank testing. While 72% of laboratories could perform type and screen and crossmatching, many lacked antibody identification capacity. Only 2 hospitals had the capacity to transfuse packed red blood cells, plasma, and platelets simultaneously if needed, with 20.6% of nonmetropolitan hospitals holding no blood products in inventory. Conclusions: The blood banking capacity of CAHs in Kansas is influenced by the lack of workforce availability and training, reduced availability of blood products, and distance from facilities where blood is processed. Solutions tailored to the unique rural environment are needed to ensure adequate access to blood for patients.