T-shirts, lunch passes, pizza parties, and promotional efforts induced a record number of hospital employees to donate blood. The author is a medical technologist in the transfusion service at St John’s Regional Health Center, Springfield, Mo.

In 1986, we transformed our hospital employee blood drives from meager activities, collecting an average of 40 units, to major events: In two summer drives that year, hospital employees donated 877 units. A new program of incentives and promotion made the difference.

Periodic blood shortages at the regional American Red Cross (the only supplier for our area) had become an accepted fact in our transfusion service. Blood donations were decreasing, not only in our city but nationwide. One reason was the fear of AIDS. Many people had the mistaken notion that blood centers reused needies, placing donors at risk of contracting the fatal disease.

As the area’s largest blood consumer, our 850-bed hospital was using an average of one-third of the Red Cross blood resources. Dangerously low supplies threatened our patients’ survival. Beyond discussing ways to overcome periodic shortages, however, the transfusion service had long been passive about the problem-donor recruitment wasn’t part of our job.

A little more than two years ago, we decided it was time to take an active role, and the logical place to start was among our institution’s 3,000-plus employees. These employees were not aware of how much blood the institution needed. Considering the 23,000 units of blood and blood components that the hospital used annually, donations from the staff were embarrassingly low.

With administration’s support, the transfusion service, the public relations department, and the personnel department planned to stimulate a large turnout for the June 1986 hospital blood drive. They decided to furnish incentives for individual donations, to recognize department levels of participation, and to publicize the drive extensively.

Each employee who gave blood would receive a T-shirt featuring the cartoon character Ziggy, a cafeteria lunch pass, and the chance to win $50 in either a drawing for first-time donors or a drawing for previous donors. Pizza parties were to be thrown in the department with the largest number of donors and in the department with the highest percentage of donors.

Fliers announcing the blood drive and the incentives were posted at every time clock. A letter from the hospital’s executive vice president, encouraging participation, accompanied paychecks. An article in the hospital newsletter pointed out how much blood our patients had required recently, and several case studies helped dramatize the need.

The day before the drive, the transfusion service set up a table by the cafeteria to hand out donor information pamphlets. We also answered employee questions about eligibility requirements, drive times, and the location.

These promotional efforts paid off handsomely. By the end of the drive on the following day, 365 employees had shown up to donate. With 43 deferred for various reasons, the Red Cross bloodmobile collected 322 units. That set a record for employee bloodmobiles in Springfield, Mo., a city with a population of 142,000.

After recovering from this overwhelming response, we began planning for our next scheduled drive two months later, ‘in August. Could we do it better the second time around?

A problem in scheduling times for donation had become apparent during the June drive. Three hundred employees, the great majority of donors, had to wait in line during the middle of the day to give blood. Also, the 9 a.m. to 5 p.m. drive did not give the night shift an opportunity to donate.

First, we extended the forthcoming drive to two days so we could more easily accommodate a large turnout of donors. Blood collection would start late on the first day, 3 p.m. to 7 p.m., and early on the second day, 7 a. m. to 3 p.m., enabling all shifts to participate. Two mini-mobiles were arranged for a nursing home and psychiatric facility that are part of our hospital.

For further convenience, employees were given the option of going to the Red Cross center four blocks away. Donating took less time there because the lines were shorter. Employees would bring back proof of donation to receive their T-shirt and lunch pass.

To our amazement, 580 employees came to donate at the bloodmobiles, and 90 went to the Red Cross. Of these, 93 were deferred, and 22 yielded short-draw units that had to be discarded. That still left 555 units collected! We had succeeded in breaking our own record for the largest employee blood drive in the city.

Getting regular and occasional donors to participate was not the only goal. A prime objective was to recruit those who had never donated before. The June drive enlisted 112 first-time donors, and the August drive brought in an additional 133. Red Cross personnel and hospital administration recognized that recruitment of 245 new donors during the usually slow summer months was quite an accomplishment.

In the past, the use of incentives and other promotional tactics to elicit donations has been questioned. One argument made against incentives is that they may encourage donors to lie about their medical history. The concept of “payment” for blood donations is taboo to many. That and doubts about cost-effectiveness have probably kept such blood drive promotions from being widely used.

We had 899 donors in the two drives; excluding the 22 shortdraw units, we collected 877 units of blood. The total outlay for our two blood drives was $6,114, which amounts to $6.97 per unit collected (a cost breakdown is shown in Figure 1). Is $6.97 per person-mainly in the form of Tshirts and lunch passes-too much to pay for an act that accomplishes so much’? And would anyone be induced to lie by such modest incentives?

This money, paying for tokens of appreciation, is not recovered In any way. Many other hospital activities or community events cost as much or more to conduct, and they do not bring about the tangible medical benefits that are present in a unit of human blood.

By spending $6.97 per person, we significantly increased the area’s blood supply for the Independence Day and Labor Day holidays, when there are usually a drop in donations and a rise in demand. We also expanded the donor population by a substantial number. Higher employee morale and awareness of blood needs at the hospital were evident. We proved that even for blood donations, incentives and adequate promotion get results.

Snags, inefficiencies, mis-, takes, and oversights were bound to affect a project of this size, especially one that had been run by novices at donor recruitment. We wanted to avoid the same problems the next time around.

For example, some regular hospital donors missed out on the incentives during the June 1986 drive because they had recently given blood and the 56-day period required between donations had not elapsed. On the other hand, hospital employees ready to give blood might hold off going to the Red Cross center and instead wait for the next drive in order to receive the incentives.

To solve such problems, we arranged to give individual and departmental incentive credit for any donation by a hospital employee at the Red Cross center, between regularly scheduled blood drives.

We also decided to limit the number of full-scale drives to two a year, one in the summer and one in the winter, because we cannot handle any more than that. These now take place over a day’s time, instead of two, from 7 a. m . to 7 p. m.

Our success continues. From the December 1986 drive until the next drive, there were 463 employee donors, including 39 firsttimers; from the May 1987 one, there were 531 donors, including 50 first-timers; from the December 1987 one, there were 664 donors, including 59 first-timers; and from July 1988 to mid-August, there were 651 donors, including 84 first-timers.

Surgery (with a staff of 170) has won pizza parties twice for having the largest number of blood donors, and the business department (with a staff of only 29) has won twice for having the highest percentage of donors. The laboratory has been a close runner-up on total number of donors, once missing out on a party by only three units of blood.

Activity between drives stepped up in August 1988, when we began parking a bloodmobile in front of the hospital twice a month. This encourages visitors, employees, and anyone who happens to be at the hospital to donate. Employees who use this opportunity also receive the incentives.

The added responsibilities of promoter, recruiter, T-shirt designer and distributor, and public relations representative initially looked like too much work for nine transfusion staff members to take on. As we saw our efforts pay off in record-breaking blood drives, the burden grew much lighter.