WASHINGTON -- The board of directors of the American Red Cross voted unanimously yesterday for a sweeping reorganization of the way it collects and handles blood in a move intended to restore confidence in a system that has too often come close to shipping contaminated blood for transfusions.
The plan, to be announced this morning by the Red Cross' new president, Elizabeth H. Dole, will impose new national collection and handling procedures and require the retraining of all employees at the organization's 53 blood centers.
To implement the changes, the Red Cross will shut down the centers on a staggered basis over the next two years.
Red Cross officials emphasized that the blood supplies from the centers are safer than they have ever been but said that the public's expectations, and fears, are higher than ever.
Dr. Louis W. Sullivan, secretary of health and human services and one of the Red Cross board members, said yesterday that he backed the measure because it "will make the Red Cross facilities state-of-the-art and will provide a major reassurance of the safety of the blood supply."
He said he hoped that "this exceptional management step" would help the Red Cross get the financial help it needed, about $100 million, to carry out the program. The organization plans to pay for the changes through loans, fund-raising campaigns and cuts in other parts of its budget.
Half the nation's blood supply comes from Red Cross centers. The rest comes from independent centers, less formally organized under the Association of American Blood Banks.
The reorganization is the most dramatic in the group's history. Officials said the aim was to transform this American institution from a collection of local, idiosyncratic chapters with as many different kinds of procedures as there are local directors into a national, standardized and efficiently run body more akin to a pharmaceutical company.
Under the newly approved plan, the 53 Red Cross centers will be divided into 10 regions, and centers in each area will be closed sequentially, five to eight centers at a time over the next two years.
Blood donations will be halted in each region as the blood centers are reorganized. Existing computer systems will be scrapped, new and nationally uniform procedures established, and all employees retrained to follow the new methods.
The Federal Drug Administration will inspect the centers before and after the changes are made.
While each region is shut down, the rest of the Red Cross blood collection system will be asked to collect about 10 percent more blood for distribution to the area shut down.
The most important factor in the decision to go ahead with the reorganization was the relatively new requirement that blood be tested for the AIDS virus and the hepatitis B and C viruses.
From 1985 to 1990 alone, the centers had to carry out 100 million more tests than in the previous five years.
The centers have received hundreds of citations for improper procedures in the past year from the FDA, which regulates the collection and use of blood and blood products. Most of the citations were for minor clerical errors and failure to follow strict federal guidelines.
In a six-month period in 1987-1988, an internal review by the Red Cross found that of the 6 million blood products collected and processed, more than 2,400 were improperly released. About 575,000 others were tested and properly destroyed because they were contaminated.
With multiple breakdowns in such procedures, officials feared that some contaminated blood would be sent out, infecting unsuspecting patients. That kind of error could cost the Red Cross greatly in lawsuits as well as the good will the group has enjoyed.
FDA investigations also showed that the errors were not being properly reported to the government.
Red Cross and federal officials said that each set of regional centers would be shut for about eight weeks, during which time a team of officials would carry out the reorganization and training.
The reorganization follows a narrower attempt at reorganization announced last year, which placed a "principal medical officer," paid by the national rather than the local office, in each of the 53 centers to help bring them up to national Red Cross and FDA standards.
But Red Cross officials said that action was not enough because federal inspectors continued to find erratic practices at the centers.