An Academic-Based Hospital Donor Site: Do Physicians Donate Blood?
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Annals of Clinical & Laboratory Science, vol. 39, no. 4, 2009 339
An Academic-Based Hospital Donor Site:
Do Physicians Donate Blood?
William A. Kanner, Susanne Jeffus, and Gay Wehrli
Department of Pathology, University of Virginia Health System, Charlottesville, Virginia
Abstract. The objectives of this prospective, cross-sectional study were to characterize blood donors in an
academic-based hospital donor center, to determine whether physicians donate, and to elucidate the
donation impetus. A confidential survey was issued to presenting, potential donors over 200 weekdays.
Three questions were asked: their role at the institution, if and when they had previously donated blood,
and what prompted the current donation. The majority of the 687 respondents were institution-affiliated
(73.5%) and 79.3% had previously donated, with a median of 3 mo since the prior donation. Only 21
(3.1%) respondents were physicians. The predominant reasons for donor presentation were an appointment,
knowing it had been 8 wk since the last donation, and contact by the blood center to donate. This study
shows the dearth of physician blood donors and a strong cohort of institution-affiliated repeat donors.
Physicians represent a potential, stable, and sustainable donor pool; further studies are needed to establish
physician recruitment programs.
Keywords: physician blood donors, donor center, blood donation, donor recruitment
Introduction Conventional estimates suggest that 60% of the
total US population is eligible to donate blood.
The Nationwide Blood Collection and Utilization However, this may be a gross overestimate [2-5].
Survey Report (NBCUS) showed an improved Accounting for donor exclusions, Riley et al [3]
margin between supply and utilization for available, lowered the percentage of eligible donors to 37.8%.
allogeneic whole blood and red blood cell units Participation decline is well documented in the
(WB and RBC) in 2006 (7.8%) vs 2004 (4.5%) [1]. literature with potential causes that include reduced
This improvement was substantiated by an increase altruism, increased deferrals, and a decreased donor
in collections, particularly automated collections, pool [3,6-8]. There is ongoing discussion about
with a concomitant decrease in units discarded for donor motivation and the need to expand the donor
reactive testing [1]. Allogeneic blood collections per population in number and diversity [6,9-14].
one thousand United States population, age 18 to Creating and maintaining a safe, sustainable donor
64 yr, increased to 84.1 in 2006, from 83.1 in 2004 pool to meet utilization needs is a challenge for
[1]. This calculated increase does not account for blood centers in the USA and around the world.
16- and 17-yr-old donors, an adjustment that Studies addressing donor demographics such
reduces the collection rate to 80.3 units per one as age, race and ethnicity, gender, education, and
thousand US population, age 16 to 64 yr [1]. place of birth are well represented in the literature
[6,10,14-20]. The Retrovirus Epidemiology Donor
Address correspondence to Gay Wehrli, M.D., Blood Bank Study (REDS) Group, initiated in 1989 by the
and Transfusion Medicine Services, University of Virginia National Heart, Lung, and Blood Institute, contin-
Health System, PO Box 800286, Charlottesville, VA 22908, uously provides donor data and demographics
USA; tel 434 924 2275; fax 434 924 8307; e-mail gw6r@
virginia.edu.
[15,17,20-23]. Wu et al [15] for the REDS Group
0091-7370/09/0400-0339. $2.45. © 2009 by the Association of Clinical Scientists, Inc.340 Annals of Clinical & Laboratory Science, vol. 39, no. 4, 2009 showed that in 1991-1996 the preponderance of (desire to help others), social obligation, awareness first-time donors was under 35-yr old, white (non- of need, and social pressure; convenience also plays Hispanic), male, USA born, and with at least a a role [20,22]. Over one-half the USA population college education [15]. A 2003 REDS survey participates in volunteer activities, but only 5% showed that the top motivators remain altruism donate blood annually [20]. Despite the rich Fig. 1. UVA-VBS donor room survey.
Do physicians donate blood? 341
literature on blood donation, very little speaks to rate. As noted by these numbers, some donors
academic-based hospital donor rooms, and in chose not to complete the voluntary survey. Fifteen
particular, to physicians as donors [11,24]. potential donors did not respond to question #1.
The University of Virginia Health System Table 1 lists the 672 respondents’ roles (Visitors,
(UVAHS) features a 587-bed academic medical Students, Administrators, Healthcare Providers,
center providing primary through tertiary care Faculty, Support Services, Other Employees, or
services and transfusing >20,000 RBC units Students). Two of the major donor categories were
annually. The medical center is staffed by 1,588 visitor and student (24.9% and 23.1% of question
physicians including attending physicians, fellows, #1 respondents, respectively). Breakdown of the
residents, and interns. The UVAHS has a UVA Healthcare Provider category revealed 21
prominently located blood donor site staffed by physicians (11 attending physicians and 10 intern/
Virginia Blood Services (VBS). The UVA-VBS resident/fellow physicians), comprising 21% of the
donor room is open on Monday, Tuesday, and Healthcare Provider category and only 3.1% of all
Thursday from 8:30 am to 4:00 pm, on Wednesday question #1 respondents.
from 8:30 am to 7:00 pm, and on Friday from 7:30 Question #2 was completed by 681 respondents
am to 3:00 pm. In 2008, whole blood collections revealing 136 (19.8%) first-time and 545 (79.3%)
averaged 79.5 units per mo. returning donors to the UVA-VBS donor room.
The UVA Institutional Review Board for Of the latter 545 donors, 522 provided the number
Health Sciences Research provided this study an of mo that had elapsed since their last UVA-VBS
exemption. The objectives of this prospective, cross- donation. Despite the broad range (1-151 mo) the
sectional study were: (1) to characterize donors in median was 3 mo and the 90th percentile was 13
the academic-based hospital donor room, (2) to mo. Analysis of the first-time donor responses (132
determine whether physicians donate, (3) to answered both question #1 and question #2)
differentiate first-time versus repeat donors and revealed that 53.8% were visitors. Returning donors
assess the time since last donation for the latter, (535 respondents to both questions) were
and (4) to elucidate the donors’ impetuses for predominantly students (21.7%) and support
presenting to donate. services (21.7%), with visitors a close third (17.6%).
Twenty of the 21 physicians answered both question
Materials and Methods #1 and question #2. Three of the 4 first-time donors
were attending physicians as were 8 of 16 returning
The UVA-VBS phlebotomist issued a confidential, self physician donors. The 16 returning physician
administered, survey to all potential donors presenting in the
donors on average came back after 10.5 mo (range
donor room over 200 weekdays from 19 March through 31
December 2008. This voluntary UVA-VBS donor room 2 to 24 mo).
survey was brief and straightforward, requiring only one to Just over 98% of respondents answered
two min for responses. The front side of the single sheet question #3 to identify the impetus for the current
provided the rationale, confidentiality, and voluntary nature donation. As shown in Table 2, the top 3 reasons
of the survey. As shown in Fig. 1, the back side of the sheet
had three questions: (1) to select the respondent’s role in the
were having an appointment (25.6%), knowing 8
institution from 38 subcategories, (2) to identify if the weeks had elapsed since the last donation (22.2%),
respondent is a first-time donor at this donor room, and if not, and receipt of a VBS reminder to donate (20.6%).
how many mo had lapsed since the prior donation, and (3) to Walk-ins were the fourth reason (16.4%) for all
describe what prompted the current donation. The surveys
categories of donors, but this was the top reason
were collectively reviewed by the authors. The raw data was
entered into Microsoft Excel and analyzed by SPSS 15.0. given by visitors and first-time UVA-VBS donors.
Of 541 returning donors, 77.8% had an appoint-
Results ment, knew it had been about 8 weeks since last
donation, or were contacted by VBS to come and
During the 200-day study timeframe, 687 potential donate. One-third (33.3%) of the physicians were
donors completed surveys and 739 whole blood also walk-in donors. The most frequent donors (295
units were collected, representing a 93% response donors who presented 1-3 mo since prior donation)342 Annals of Clinical & Laboratory Science, vol. 39, no. 4, 2009
Table 1. Self-reported role at UVA by category (total) and subcategory for 672 respondents.
UVA Visitors (167) UVA Faculty (nonphysicians, 52)
• Visitor, family member in hospital 41 • Undergraduate Faculty 9
• Visitor, friend in hospital 11 • Graduate Faculty 17
• Visitor, all other visitors 115 • Research Faculty 26
UVA Students (155) UVA Support Services (132)
• Undergraduate Student 36 • Assistant 40
• Masters Degree Student 13 • Environmental Services 3
• PhD Degree Student 39 • Facilities Management 7
• Post-doctoral Fellow 3 • Health System Computing Services 3
• Dental Student 0 • Human Resources 4
• Medical Student 57 • Information Technology/Communication 19
• Nursing Student 7 • Library Services 1
• Maintenance Services 7
UVA Administrators (27) • Nutrition (Food) Services 1
• Administrator 27 • Parking and Transportation Services 0
• Patient Financial Services 2
UVA Healthcare Provider (100) • Secretary 14
• Attending Physician 11 • Social Work Services 1
• Intern/Resident/Fellow Physician 10 • Volunteer Services (Volunteer Worker) 0
• Nurse (RN, LVN, LPN) 33 • Other Support Services 30
• Nurse Practitioner or Anesthetist 1
• Physician’s Assistant 2 Other UVA Employees or Students (39)
• Technologist 21 • Other Healthcare Provider 22
• Research Assistant/Associate/Coordinator 1
• Other 38
Table 2: Self-reported impetus for current blood donation.
Reason Number of respondents
I had scheduled an appointment to donate today 173
I walked by, saw the donation center, and came in to donate 111
A friend was coming to donate and asked me to come with him/her 30
Someone suggested I come to donate 21
I was contacted by Virginia Blood Services (VBS) to come and donate 139
I knew it had been about 8 weeks since my last donation 150
Other 52
Total Respondents 676
most commonly presented because they knew it [6,9-16,19-22,24,25]. A study from the Blood
had been about 8 weeks since their last donation Center of Umea University Hospital in Sweden
(33.2%) or because they had an appointment showed that among motives for donating blood,
(30.5%). Donors presenting 3.5-12 mo since the healthcare occupation represented only 7.7% of the
last donation (170) also came with an appointment donors [13]. Misje et al [12] from the Blood Bank
(28.8%), following a contact from VBS (22.3%), or of Oslo, Norway, found 12.4% of their donors
because it had been about 8 weeks (21.2%). worked in health and social sciences, a percentage
smaller than that of the total work force (17.6%).
Discussion These authors expressed surprise that healthcare
professionals were under-represented [12].
The literature is rich with demographics and This prospective, cross-sectional pilot study
motives for blood donation, although little elucidated donor characteristics at the UVA-VBS
information is available about physicians as donors donor room and confirmed our supposition thatDo physicians donate blood? 343
physicians represent a tiny minority of the donors. annual donation from each of the predicted 997
Of 687 survey respondents, only 21 (3.1%) were eligible physicians would double the collection rate
physicians. In fact, the healthcare provider category in the UVA-VBS donor room and two annual
with 100 donors was surpassed by visitors (167) donations would cover 10% of the UVAHS red cell
and support services (132). The returning physician transfusions.
donors (16) came back a median of 12 mo after a There is a consistent, pervasive message in the
prior donation, a lapse 9 mo longer than for all donor literature that we urgently need new,
returning donors (median 3 mo). One-third innovative, and effective donor recruitment models
(33.3%) of physician donors presented as walk-in [2,3,14,17,19-21,25,27,28]. Donor recruitment and
donors, two times that of the total survey retention strategies should reflect demographic
respondents (16.2%). The survey showed a strong changes in USA race and ethnicity [3,10,15,17].
cohort of returning donors (76.0%) who presented Commonly cited reasons for not donating have
with an appointment, who were self-directed 8 remained unchanged over decades and include not
weeks after a prior donation, or who were reminded being asked to donate, lack of awareness of the need
to donate by a contact from VBS. for blood, fear, and lack of time or convenience [2,
We identified several limitations during the 6,10,11,13,14,16,19,20,25]. Perhaps community-
course of this study. One of the common challenges based campaigns expressing the community’s blood
with survey-based research is the response rate. To needs and addressing the latter obstacles could
maintain simplicity we limited the survey to one prove more effective [2,14,15].
page with three questions and circled responses. Considering the hospital community, it would
This brevity restricted the variables studied, which appear intuitive for physicians to understand the
could have easily been expanded to include more utilization challenges of balancing the supply and
detailed demographic and motivational questions. demand for blood products. We would expect
Despite the simplicity, there were at least 52 physicians to have high awareness of the need for
nonresponders, based on the number of whole blood donations based on their daily activities
blood units collected, contributing to nonsampling including ordering and administering blood
error. The ad hoc VBS-sponsored blood drives products to patients, yet we did not see many
based in the hospital, outside of the UVA-VBS physician donors. This suggests a need to better
donor room, were a confounding factor, in that understand physician motivators and donation
these were not accounted for in our study. At times, obstacles, to create and implement physician
these drives overlapped the donor room hours, recruitment models, and to retain physician donors.
detracting from the donor room collections and During the course of this study, on 27 September
creating further nonsampling error. Nevertheless, 2008, we implemented extended UVA-VBS donor
the extended timeframe and total respondent room hours (from 4:00 pm closing to 7:00 pm
numbers expanded our knowledge base for an closing) to provide more opportunity for physician
academic medical center-based donor room and for donations. This was an initial step, and we have
physician donors. many more to take. Our plans to increase UVAHS
There are roughly 814,000 licensed physicians physician donors include brief educational sessions
in the USA, of whom about 1,588 work at UVAHS during departmental grand rounds. These sessions
[26]. Assuming all licensed physicians are 18-65 will address the blood supply challenges, the need
years old and applying the Riley et al [3] model for donors, and the UVA-VBS donor room,
(62.8% of 18-65 year old population as eligible including general information and current donation
donors) suggests 511,192 USA and 997 UVAHS opportunities. We will conclude these sessions
physicians are eligible to donate. Numerically, this with a physician-directed survey to ascertain their
represents a substantial pool of potential donors. obstacles to donation and how our donor center
Two annual donations from each eligible physician can help them to overcome these obstacles. The
in the USA would cover about 7% of allogeneic red survey results will guide subsequent interventions
cell transfusions nationwide [1]. At UVAHS one to increase physician donors. The UVA-VBS donor344 Annals of Clinical & Laboratory Science, vol. 39, no. 4, 2009
room survey (Fig. 1) will continue to be used and 12. Misje AH, Bosnes V, Gasdal O, Heier HE. Motivation,
recruitment and retention of voluntary non-remunerated blood
modified as needed to monitor improvements donors: a survey-based questionnaire study. Vox Sang 2005;
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13. Sojka BN, Sojka P. The blood donation experience: self-reported
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represented yet potentially substantial donor pool 94:56-63.
within UVAHS and presumably throughout the 14. Steele WR, Schreiber GB, Guiltinan A, Nass C, Glynn SA,
Wright DJ, Kessler D, Schlumpf KS, Tu Y, Smith JW, Garratty
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