New York Blood Center Enterprise's Response To COVID-19

Nonprofit organizations are uniquely positioned to lead in times of uncertainty and crisis, and unusual times call for extraordinary leadership. Eighty-three percent of nonprofits agree that technology is imperative to their success, and less than a quarter of these same nonprofits indicated a long-term strategy to digitally transform.

As we move into post-pandemic and universally strive towards the next normal, Salesforce is sharing best practices in a playbook to help take incremental steps to reopen. We've learned from nonprofit leaders, that technology solutions and strategy are helping to knit together conversation across teams, from compliance to client services, talent development, donors and volunteers, to business and legal operations.

New York Blood Center

New York Blood Center (NYBCe), located in the epicenter of the pandemic, share their response to reopening, as well as reflections and advice for delivering on a mission today. We spoke with Elisabeth M. Scaffidi, marketing manager at NYBCe, and Dorian Deschesne-Walsh, CRM and marketing platforms administrator, to learn how NYBCe transitioned from stabilization, to reopen and growth phases of response to the COVID-19 pandemic.

New York Blood Center Enterprise's Response to COVID-19

In these challenging times, how an organization responds to a crisis is critical to success. The unique circumstances due to the COVID-19 pandemic have created mass disruption across all industries, including non-profit organizations and specifically blood centers. Blood centers are considered critical infrastructure and must continue operations regardless of the obstacles in maintaining a safe and adequate blood supply. While blood products are highly regulated and mandated by the FDA and industry accreditation agency standards, these products must also adhere to local and state regulations and licensing requirements. Part of meeting criteria also includes having a robust emergency management protocol to ensure the safety of our staff and donors, while meeting the responsibility to hospitals and the patients they serve.

New York Blood Center Enterprises (NYBCe) is one of the largest independent, community-based blood centers in the world in providing life-saving blood and blood services to nearly every hospital across the five boroughs in New York City as well as the whole tri-state area (NY, NJ, CT), Mid Atlantic area (PA, DE, MD, VA), Missouri and Kansas, Minnesota, Nebraska, Rhode Island, and Southern New England.

Since the opening of NYBCe in 1964, the organization has had to operate in times of crisis, such as 9/11 and Hurricane Sandy; however, the unanticipated complexity of operating through a pandemic and quarantine requires strong leadership, organizational unity, creativity, dedication, and perseverance. NYBCe has built on their 55+ years of experience to develop strategies that address the unique considerations of a pandemic and quarantine. Having leaders and experts in the transfusion medicine field with active roles in many associations and committees has aided in the development of recent standards and has helped us to collaborate with other blood centers to develop standardized protocols.

Salesforce's COVID-19 Response Playbook outlines the processes and best practices that organizations should think about as they navigate this new climate. Here is how NYBCe has positioned themselves in response to COVID-19, while strategically taking action to navigate through these uncertain times.

Stabilize

Beginning in early March, New York City and the surrounding areas saw a rapid increase of positive coronavirus cases that resulted in immediate disruptions to NYBCe operations. NYBCe preemptively prepared for upcoming challenges to maintain blood inventory and blood products consistent with their hospital client's needs as 75% percent of blood donations in the NY region are sourced from mobile blood drives hosted by schools, organizations, and businesses. As various communities, schools and businesses began taking precautions in response to the COVID-19 outbreak, NYBCe rapidly began receiving notification of canceled blood drives for March, while proactively canceling drives for all of April and most in May, which naturally posed a significant threat to the blood supply. Because blood is perishable and the supply must constantly be replenished, it remains a critical component of emergency preparedness. 

In NYBCe's initial weeks of stabilization, significant efforts were made organization-wide to ensure the safety of staff, donors, and blood supply which included the following:

• Keeping the NYBCe staff safe and healthy as a key priority by encouraging everyone to follow standard guidelines for infection control, including routine hand washing and staying home if they are experiencing symptoms of a respiratory infection.
• Communicating internally and externally about the importance of healthy donors scheduling donation appointments.
• Engaging with media to encourage people to continue donating and to reassure them that donating blood is safe.
• Encouraging our hospital clients to leverage their existing blood inventory and make adjustments to their standing orders to contribute to helping the center maintain a safe level over the next few months.

The blood that is on the shelf today is the blood that will save lives in an emergency. Fortunately, hospitals were quick to initiate blood conservation practices, such as postponing elective surgeries to reduce the burden on the community blood supply. The nationwide quarantine resulted in a dramatic reduction in traumas, which helped alleviate the short-term demand for blood. 

Reopen

NYBCe had taken measures to protect its mobile staff to ensure that they continue to serve its stakeholders during the challenging COVID-19 outbreak. The safety and well-being of its staff and donors continued to be paramount during the "reopen" period, so NYBCe initiated an inter-departmental task force to plan for continuing operations while addressing safety across all operational areas:

Blood collection sites:

• Blood donations limited to brick and mortar donor centers; mobile drives canceled.
• Donations by appointment only to maintain social distancing.
• Blood collection sites disinfected frequently, as per CDC recommendations.
• NYBCe staff practice health self-assessments prior to presenting at work.
• As always, people are not eligible to donate if they are experiencing a cold, sore throat, respiratory infection, or flu-like symptoms.

Manufacturing, Distribution, and Laboratory sites:

• PPE for all staff
• Staggered shifts for social distancing
• Suspension of non-critical on-site projects
• Issuing NYBC credentials affirming essential worker status
• Updating SOPs to include new government mandates and industry guidelines

All Staff and Corporate Offices:

• Work from home for all non-essential staff
• Suspension of all business travel
• Re-evaluation of benefits, i.e. unused mass transit and childcare expense accounts
• Collaboration with unions to ensure compliance with agreements and update where appropriate

As the organization has stepped up to provide for the critical needs of patients during COVID-19, the pandemic has had a devastating financial impact at a moment when its services could not be more crucial. NYBCe had and is stretching its limited resources with increased and new costs in lab equipment, cleaning and disinfecting supplies, personal protective equipment, and donor recruitment outreach.

Grow

NYBCe, with its corporate headquarters and two manufacturing and laboratory facilities in the epicenter of NYC, was able to pivot operations from community blood drives to collection of Convalescent Plasma and leverage our existing expertise through research to innovate during a global crisis.

Throughout the stabilization and reopening efforts, they continued to reinforce the first point of its mission:

"To provide the highest quality blood and stem cell products and related medical and consultative services to hospitals and patients."

The unity, dedication, and commitment of our organization have allowed for an uninterrupted flow of blood products and related transfusion services to support traumas, transplants, elective surgeries, and therapeutic transfusions that are restarting. Additionally, NYBCe has exceeded its mandate to meet the unique demands of this pandemic by expanding its laboratory capacity and increasing their donor recruitment outreach to develop a 'first in the nation' COVID-19 convalescent plasma (CCP) program. These efforts reinforced their second point of their mission:

"To develop products, technologies, and services in the fields of hematology, blood banking, and transfusion medicine and cellular therapies, with the potential to have worldwide humanitarian impact."

Convalescent Plasma Therapy: Its team of medical professionals and researchers developed an early partnership with Mt. Sinai Health System and Columbia-Presbyterian Hospital to collect plasma from recovered COVID-19 patients and, in late March, they were the first blood center to collect, process, and distribute convalescent plasma. NYBCe has shipped over 10,000 plasma units to healthcare facilities throughout the USA, and its goal is to expand operations to provide CCP to any COVID-19 patient who needs it.

COVID-19 Research Repository (CRR): Research of this novel coronavirus is critical to designing effective therapies and preventing future pandemics. This understanding has led to the development of NYBCe's COVID-19 Research Repository (CRR), in which its purpose is to archive blood components, including plasma, serum, and immune cells, from COVID-19 patients to preserve these critical materials for continued future research with the long-term goal of fostering collaborative research between NYBCe investigators and the scientific community to accelerate the knowledge and understanding of SARS-CoV-2.

Vaccine development: In a matter of three months, NYBCe scientists were able to apply over a decade's worth of expertise and knowledge in developing vaccines for Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS), to identify and design two novel vaccine candidates. The construction of the vaccine development is undergoing patent review while both vaccines are currently in the pre-clinical trial phases and are being developed for safety, efficacy, and manufactural capability for emergent use. If the vaccine candidates prove to be effective, phase 1 clinical trials would begin at the end of the summer.

Antibody Testing: To support COVID-19 response and workforce restoration, NYBCe focuses their efforts toward determining individuals at risk for severe disease and understanding the immune response to SARS-CoV-2. The organization is testing the general population to study the prevalence of antibodies which will provide information as to how many individuals per capita "had" and have recovered from COVID19. NYBCe is using its network of hospitals and blood banks to achieve this which extends point three of our mission:

"To conduct the highest quality, novel and innovative research in the fields of hematology, blood banking and transfusion medicine, and cellular therapies, thus advancing these fields and positively impacting the public health."

Sustaining momentum

As mentioned, this pandemic has left a financial impact on NYBCe via increased expenditures relating to necessary public health measures such as social distancing, and significantly decreased revenues resulting from reductions in blood use due to elective surgery cancellations, leaving NYBCe in need to quickly ramp up fundraising efforts to offset expenses associated with COVID-19 and funding for related research and development. New projects developed in response to the crisis have created an increased need for funds critical to supporting the design of effective therapies and preventing future pandemics. Luckily, its contributions toward COVID-19 relief have led to an abundant amount of media attention to its mission, attracting offers of support for research, infrastructure, and future disaster relief planning.

As regions prepare to reopen and hospitals start to perform elective surgeries, the need for blood has rebounded to pre-COVID-19 levels and higher, but the blood supply is still dangerously low. NYBCe will begin holding a limited number of mobile blood drives each week, but they are far from the 600 drives per month that would be required to meet the need at area hospitals. To ensure an ongoing sufficient blood supply, the enterprise will need to fund operational expenses such as opening new donor centers, purchasing new machines, and extend mass communication to the public. 

Pandemic Response Lessons Learned

The adoption of cloud-based tools is a must to reduce operational disruption. Our existing digital transformation plans were accelerated to accommodate the "new normal" working environment, including updating legacy software, automating processes, education, and training to support the adoption of new tools and virtual collaboration. NYBCe had already started to adopt cloud-based tools and partial-remote work options for some positions. However, NYBCe has been able to significantly expand its use of virtual collaboration more successfully than anticipated.

How NYBCe has responded during this time is how we strive to be remembered. As other industries are evaluating their responses, NYBCe offers the following guidance for nonprofits, community, and/or business to consider:

• Acquire leadership support (mentors and sponsors) - Strong leadership, unity, and the dedication and expertise of our workforce has been critical to maintaining the quality, consistency, and morale of the entire organization.
• Build on existing expertise - Our research accomplishments include years of work by our experts in virology, immunology, as well as test and device development, which have positioned us to offer major and rapid contributions to the fight against COVID-19.
• Be flexible – NYBCe was able to strategically find ways to continue operations under new restrictions and pivot the focus of our expertise and resources to areas of urgent need.
• Leverage partnerships – Be open to partnerships with like-minded organizations for collaboration opportunities with shared benefits. NYBCe partnered early on with Mt. Sinai and Columbia Presbyterian to develop the use of convalescent plasma for critically ill COVID-19 patients, as well as major government agencies and research organizations to develop vaccine candidates, antibody testing and research, and an entirely new research endeavor to strengthen our understanding of the disease for the global good.
• Invite sponsors and donors - Leverage existing relationships with vendors and key customers to keep costs at a minimum and make use of new/enhanced support resources they may offer. Look into opportunities for grants, relief funding, etc. Many large philanthropic foundations are looking to contribute to organizations that are making a difference.

This article was co-authored by Katie Pouga, Salesforce.