A benchmarking program to reduce red blood cell outdating: implementation, evaluation, and a conceptual framework

Barty, Rebecca; Gagliardi, K; Owens, Wendy; Lauzon, Deborah; Scheuermann, Sheena; Liu, Yang; Wang, Grace; Pai, Menaka; Heddle, Nancy M.

doi:10.1111/trf.13055

Cited by 6 publications

(7 citation statements)

References 8 publications

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“…Blood bank technologists ordered blood products with little guidance, and this practice often overemphasized minimizing shortages. The average monthly RBC shortage and outdate rates were reported to be consistently less than 2%, similar to comparable institutions in Canada . However, historical utilization data revealed that a significantly greater proportion of older RBC units were transfused at the hospital when benchmarked against published data from other large tertiary care hospitals in North America.…”

Section: Introductionmentioning

confidence: 79%

“…Current RBC supply and inventory management approaches focus on conventional KPIs, such as the ODR . However, these approaches are unable to adequately assess performance when applied to a large tertiary care centre with rapid RBC turnover and a redistribution program.…”

Section: Discussionmentioning

confidence: 99%

“…Though benchmarking targets will differ by jurisdiction, future efforts may define a range of targets for best practice . Process mapping and further expansion of multimodal strategies for improving KPIs may also aid in assisting future initiatives to improve RBC supply chains .…”

Section: Discussionmentioning

confidence: 99%

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Establishing performance management objectives and measurements of red blood cell inventory planning in a large tertiary care hospital in British Columbia, Canada

Shih

Sham

et al. 2018

ISBT Science Series

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Background Traditional key performance indicators (KPIs) for red blood cell (RBC) inventory management such as blood shortage rate (BSR) and outdate rate (ODR) alone are observed to be insensitive for large hospitals, often due to fluctuating demands and rapid turnover. We hypothesized that improvement in complementary KPIs for RBC supply chains, including age of blood as a surrogate for the pre‐hospital and in‐hospital supply chains, may further improve efficiency. Methods Red blood cell supply, inventory and disposition data from a large tertiary care hospital blood bank were retrospectively assessed from June 2014 to 2015 as the baseline period. From June 2015 to 2016, (1) collaboration with the blood supplier to improve logistics and (2) a ‘demand‐driven inventory planning policy’ (DDIP) to determine better inventory levels aided by discrete‐event simulation modelling were instituted. Age of blood transfused (ABT) was chosen as the main KPI for the efficiency of the entire RBC supply chain. Results Improvements in age of blood received (ABR) led to the greatest efficiency gains. Reduction in ABT (28.7 ± 8.8 days vs. 22.1 ± 9.5 days, P < 0.01), ABR (19.4 ± 8.8 days vs. 13.4 ± 7.0 days, P < 0.01), inventory‐to‐transfusion ratio (P < 0.01), O‐negative RBC utilization (7.4 vs. 6.4 units/day, P < 0.01) and ODR (P < 0.01) compared to the baseline period was observed without a significant increase in BSR. Conclusion Collaboration with the blood supplier to improve logistics, implementation of DDIP to determine better inventory levels and use of KPIs other than BSR and ODR led to inventory efficiency gains in a large tertiary care hospital blood bank.

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Section: Introductionmentioning

confidence: 79%

Section: Discussionmentioning

confidence: 99%

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Establishing performance management objectives and measurements of red blood cell inventory planning in a large tertiary care hospital in British Columbia, Canada

Shih

Sham

et al. 2018

ISBT Science Series

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“…Demand variability, distance from the blood supplier, the relatively short expiry period of RBCs, and requirement to manage multiple peripheral hospitals account for some of the challenges of regional hospital blood banks. RBC outdate targets are often based on distance from the blood supply provider and transfusion volume . This is expressed as WAPI taking into account the difference in RBCs received allowing for national and international comparison .…”

Section: Discussionmentioning

confidence: 99%

Zeroing in on red blood cell unit expiry

et al. 2017

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BACKGROUND Expiry of red blood cell (RBC) units is a significant contributor to wastage of precious voluntary donations. Effective strategies aimed at optimal resource utilization are required to minimize wastage. STUDY DESIGN AND METHODS This retrospective study analyzed the strategic measures implemented to reduce expiry of RBC units in an Australian tertiary regional hospital. The measures, which included inventory rearrangement, effective stock rotation, and the number of emergency courier services required during a 24‐month period, were evaluated. RESULTS There was no wastage of RBC units due to expiry over the 12 months after policy changes. Before these changes, approximately half of RBC wastage (261/511) was due to expiry. The total number of transfusions remained constant in this period and there was no increase in the use of emergency couriers. Policy changes implemented were decreasing the RBC inventory level by one‐third and effective stock rotation and using a computerized system to link the transfusion services across the area. Effective stock rotation resulted in a reduction in older blood (>28 days) received in the main laboratory rotated from peripheral hospitals, down from 6%‐41% to 0%‐2.5%. CONCLUSION Age‐related expiry of blood products is preventable and can be significantly reduced by improving practices in the pathology service. This study provides proof of principle for “zero tolerance for RBC unit expiry” across a large networked blood banking service.

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“…Significant resources are dedicated to blood bank inventory management, and optimization of inventory management remains an area of active research due to increasing cost and efficiency pressures as well as increased blood product diversity . To understand inventory performance, transfusion services commonly use key performance indicators (KPIs), such as outdate rates, wastage as a percentage of issuance, and days of inventory on hand . These KPIs are commonly used as summary descriptors of inventory efficiency and are graphed, trended, and used to benchmark institutions; however, they are inadequate to fully understand the complexity of the blood supply chain and how units interact with its processes.…”

mentioning

confidence: 99%

Process mining is an underutilized clinical research tool in transfusion medicine

2017

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A benchmarking program to reduce red blood cell outdating: implementation, evaluation, and a conceptual framework

Abstract: The Ontario benchmarking program for RBC outdating resulted in continuous and sustained quality improvement. Our conceptual iterative framework for benchmarking provides a guide for institutions implementing a benchmarking program.

Cited by 6 publications

References 8 publications

Establishing performance management objectives and measurements of red blood cell inventory planning in a large tertiary care hospital in British Columbia, Canada

Establishing performance management objectives and measurements of red blood cell inventory planning in a large tertiary care hospital in British Columbia, Canada

Zeroing in on red blood cell unit expiry

Process mining is an underutilized clinical research tool in transfusion medicine

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