AABB2026: Cleveland Blood Banks Streamline Workflows to Address Staffing Challenges

As tertiary care blood banks face growing workloads and persistent staffing challenges, leaders at Cleveland Clinic and University Hospitals Cleveland Medical Center are implementing workflow efficiencies to reduce operational burdens and make better use of available personnel.

During Sunday’s “Blood Bank Staffing in Tertiary Care Centers: Incorporating Workflow Efficiencies to Mitigate Staffing Shortages” session, Megan Hearns, MLS(ASCP), transfusion medicine laboratory manager at Cleveland Clinic; and Victoria Cary, MLS(ASCP)CM, SBBCM, blood bank manager at University Hospitals Cleveland Medical Center, shared strategies for managing staffing shortages while maintaining patient safety.

Hearns reported that between 2023 and 2025, testing volumes increased approximately 15% at University Hospitals and 4% at Cleveland Clinic, while the number of blood products transfused rose 13% and 12%, respectively.

Both institutions also experienced significant staffing challenges. The presenters shared that in 2024, functional vacancy rates reached 52% at University Hospitals and 40% at Cleveland Clinic. By 2026, those rates had declined to 12% and 21%, respectively. Hearns explained that functional vacancy includes not only unfilled positions, but also employees on leave or in training who are unavailable for independent bench work.

At University Hospitals, Cary described a two-tiered staffing contingency plan developed during the COVID-19 pandemic that helped the laboratory navigate subsequent staffing shortages and manage a 52% vacancy rate. The plan established minimum staffing requirements, identified tasks that could be deferred and outlined when additional personnel should be called in or reassigned.

Cary also highlighted workflow changes designed to reduce manual work and interruptions. University Hospitals transferred certain testing responsibilities to the core laboratory, expanded automated testing and used electronic medical record enhancements to streamline ordering and communication. These included automated reflex testing, electronic specimen signatures and revised blood product ordering processes, which reduced the need for manual consultations.

At Cleveland Clinic, Hearns described similar efforts to eliminate unnecessary work through automation, electronic documentation and expanded reference laboratory support.

Cleveland Clinic also introduced an electronic blood product release process to replace telephone requests. Hearns noted that Cleveland Clinic transfused approximately 96,000 blood products in 2025, illustrating the volume of requests previously managed through telephone communication. The institution also streamlined outpatient and oncology workflows to reduce administrative demands on laboratory personnel.

Both speakers also emphasized the importance of workforce development. Hearns discussed partnerships with human resources, structured training for new employees and career advancement pathways designed to strengthen recruitment and retention. Cary stressed the need to recognize burnout, protect staff time and maintain open communication with clinical teams and laboratory leadership.

Hearns encouraged attendees to evaluate existing workflows before shifting additional responsibilities to strained personnel. She recommended eliminating unnecessary tasks, simplifying processes, using automation where appropriate and protecting technologists from avoidable interruptions.

Attendee Aisha Grant, program director for Donor Center Process Excellence at the American Red Cross in Georgia, shared that the session inspired ideas for improving visibility into staffing challenges across the organization's divisions.

“The reports will show whether, on overbooked or underbooked days, we have a staffing issue or a planning issue,” Grant said.