Factors Influencing Blood Component Availability: The Views of Transfusion Service Leaders in Riyadh, Saudi Arabia

Background: Maintaining the availability of blood components remains a major challenge for transfusion services and healthcare institutions. Blood shortages can disrupt clinical care, complicate prioritization decisions, and place substantial operational pressure on transfusion services. Limited attention has been given to the perspectives of transfusion service personnel directly involved in shortage management, particularly within tertiary healthcare settings in Riyadh, Saudi Arabia. Methods: A cross-sectional questionnaire-based study was conducted using a structured survey designed to assess respondent and institutional characteristics, perception of blood component shortage, practices implemented during shortage, barriers affecting shortage management, and perceived strategies to improve blood component availability. A total of 94 responses were collected from transfusion service personnel working in healthcare institutions in Riyadh. Of these, 64 respondents who were directly involved in shortage management were included in the principal analytical sample. Data were analyzed using IBM SPSS Statistics for Windows, Version 26.0 (IBM Corp., Armonk, New York, United States). Descriptive statistics were used to summarize demographic, institutional, and item-level response patterns. Composite domain scores were calculated, and reliability was assessed using Cronbach's alpha. Subgroup analyses were conducted according to age, years of experience, academic qualification, and role in shortage management. Results: Blood component shortage was perceived as a meaningful and recurrent operational challenge. The mean composite scores were 3.68±0.90 for shortage perception, 4.03±0.52 for practices during shortage, 3.69±1.06 for barriers and constraints, and 4.44±0.73 for improvement strategies. The most strongly endorsed shortage-related experiences were the need for regular coordination with clinical departments and hospital leadership and the prioritization of patients or procedures during shortage periods. The most frequently reported practices included intensification of donor recruitment, close monitoring of blood inventory, and recall of repeat donors. Major perceived barriers included limited donor availability, high workload, insufficient staffing, high transfusion demand, and limited decision-making authority. Respondents showed the strongest agreement regarding improvement strategies, particularly increasing public awareness of blood donation, implementation of patient blood management programs, and establishment of a national blood service system. Postgraduate-qualified respondents demonstrated significantly higher shortage perception and stronger recognition of selected barriers. Conclusions: Blood component shortage in tertiary healthcare settings in Riyadh is perceived not merely as a donor supply issue but as a broader system-level challenge shaped by operational demands, workforce capacity, governance limitations, and institutional coordination requirements. These findings support the need for integrated interventions combining donor awareness, patient blood management, workforce strengthening, and system-level coordination to improve the resilience and sustainability of blood component availability.