The Role of Narrative Medicine and Lean Management in Umbilical Cord Blood Donation: A Story of Success.

Background/

Objectives

Umbilical cord blood (UCB) is a valuable source of hematopoietic stem cells used in treating blood and immune disorders. Despite its potential and the availability of public banking systems in Italy, donation rates remain low due to patient misinformation, emotional barriers, and organizational inefficiencies. This study aimed to evaluate the impact of integrating Narrative Medicine (NM) and Lean Management (LM) on UCB donation rates and operational effectiveness at the University Hospital of Alessandria.

Methods

This prospective, single-center pre-post study ran from July 2022 to December 2024. Two interventions were introduced: NM training for healthcare staff to enhance empathetic communication, and LM-based reorganization of workflows to improve process efficiency. Outcomes included changes in UCB donation and adherence rates, transplant-eligible unit percentages, and patient satisfaction, assessed through institutional and project-specific surveys (PERLA-SIMeN).

Results

Post-intervention, donation rates increased from 0% in early 2022 to 30.8% (2022), 25.8% (2023), and 30.6% (2024), with adherence rates near 40%, far exceeding the national average of ~3%. Patient satisfaction improved, resulting in PERLA certification in February 2025.

Conclusions

The integration of NM and LM significantly improved both patient engagement and organizational efficiency. Empathetic communication fostered trust and reduced emotional barriers, while LM optimized workflows and resource use. These results suggest the model is applicable in other hospitals to enhance UCB donation outcomes and overall quality of maternal care.