BIRMINGHAM, Ala. - Vicki Vinson used to be a regular blood donor, until a surgery and some international travel left her ineligible. But she never lost the desire to donate, and for a very good reason. Two very good reasons, in fact.

"Both of my parents have had serious medical issues in recent years," said Vinson, who works in Health System Information Services at the University of Alabama at Birmingham (UAB). "Both spent weeks in intensive care at UAB, and both needed many units of blood. Without a stable blood supply, neither would be here today."

So, when department supervisors urged UAB and University of Alabama Health Services Foundation (UAHSF) employees to donate blood during an emergency drive on Sept. 29, Vinson stepped up to the challenge. 

"I had just told my sister that I needed to resume being a blood donor," she said. "I came down to the emergency blood drive in the West Pavilion, the first time since 2006 I had been eligible to donate blood."

The drive was a last-minute effort to help UAB reach its goal of collecting 8,000 units of blood in the fiscal year. Going into the final week, it appeared the campaign would fall short by some 100 units. The emergency drive, the day before the end of the fiscal year, was the final chance - and employees responded.

Vicky Vinson, as it turned out, was the 8,000th donor. Along with 7,999 others, she helped the UAB/Red Cross Partnership reach its unit goal. The grand total of blood units collected for the year stood at 8,070 at day's end.

"We cannot begin to thank the thousands of UAB employees, students and visitors who literally rolled up their sleeves to enable us to reach our ambitious goal of 8,000 units," said Michael Waldrum, M.D., CEO of UAB Hospital.

The UAB/Red Cross Partnership is unique within the blood-collection industry. In 2005, hospital administrators met with the Red Cross to examine blood management in a fundamentally different way that would achieve UAB's patient-care goals and serve the Red Cross goals of ensuring an adequate blood supply in Alabama. The plan called for a dual-faceted approach to blood management:  increase donations while decreasing blood use.

A new blood-donation room was opened in the North Pavilion in December 2007.  The room, staffed by Red Cross employees, produced more than 4,000 units in fiscal 2009.  An aggressive schedule of blood drives was established, with four major drives per year in the North Pavilion atrium, augmented by drives at UAB Highlands, The Kirklin Clinic and other campus sites. Those drives topped 3,000 units for the year.

"We've seen an extraordinary increase in collections after launching these measures," said Mark Beddingfield, CEO of the Alabama and Central Gulf Coast Region of the Red Cross. "UAB now ranks as one of the top five blood-collection sites in the nation among health-care organizations."

Donations are up. That's half the equation. Decreasing blood use required another strategy. UAB Hospital took a hard look at procedures and policies with help from an independent consultant.

"We were looking at a dramatic culture change," said Marisa Marques, M.D., director of blood-transfusion services. "How we used blood in the medical setting had changed very little in more than 50 years."

For example, medical dogma - preached in medical school since 1949 - said that if a patient's hemoglobin level dropped to 10, he or she should be given two units of blood.  But recent studies have shown that was not necessarily in the patient's best interest.

"Transfused blood is not the same as your own blood," said Donna Salzman, M.D., co-chair of the UAB Blood Utilization and Management Committee along with Marques. "There can be toxic effects from blood transfusions, and many studies have shown that keeping hemoglobin levels between 7 and 9 produced better outcomes. Now we transfuse only when a patient's hemoglobin level drops to 7, and then we only give one unit at a time, not two, as was the standard."

There can be a number of adverse effects from blood transfusion. Some patients can have an immune response to transfused blood. Circulatory overload - too much blood - can hinder oxygen exchange in the lungs. And substances in donated blood can trigger allergies in recipients.

Another place to reduce use was in blood draws for medical tests. The typical ICU patient would give about 70cc a day for testing, and that's about a third of a unit. Three days in an ICU at that rate and a patient is becoming anemic.

"We changed our practices on blood draws - using smaller tubes, eliminating waste and reducing the number of blood draws," said Salzman. "Now an average ICU patient only loses about 39cc per day to blood draws, a significant reduction." 

The changes worked. Hospital officials estimate that, without the reductions, UAB Hospital would have needed about 45,000 units of blood this year. Instead, the hospital used just 33,000. Salzman and Marques say one thing is certain: None of this would have happened without enthusiastic buy-in from hospital administration, from nurses, from physicians and from each and every employee who donated.

"We've really come a long way," said Marques. "We have nurse champions in every unit who spearhead our efforts to better manage our blood resources. We have physicians who have embraced the changes and led the way by example. The end result is better care for our patients and a more stable blood supply for those who need it."

But there is no time to rest. The hospital will still need 30,000 to 35,000 units of blood in this fiscal year. The new goal for blood donation at UAB is even more ambitious - 9,501. 

"Reaching the new goal will be a major undertaking, but if only half of our more than 18,000 employees were to donate just once this year, we would make that goal." said Anthony Patterson, UAB Hospital associate vice president.  "This is an easy way for each of us, as individuals, to make a difference in our community."

So the blood drives will continue, and the donor room will stay open for business. Come join Vicky Vinson and the thousands of other donors. Give the gift of life.