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

Abstract

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.

Prediction of Demand for Red Blood Cells Using Artificial Intelligence Methods

“…Red blood cells (RBCs) which are a life-saving component are used to treat emergency patients [15] and also it has the highest demand among blood components (Table 1).…”

The estimated negative impacts on the red blood cell inventory of reducing shelf‐life at two large health authorities in British Columbia, Canada, using a discrete‐event simulation model

“…The difference between the minimum and maximum value represents the number of RBC units ordered to replenish the hospital's general inventory at 8:00 AM. These minimum and maximum inventories were determined using historical inventory modelling, previously validated to reduce ODRs [11]. PHC, however, requests RBC through a standing daily order delivery system, where the order sizes are modified in the morning at the PHC technologist's discretion.…”

“…Discrete-event simulation was used to model operational RBC supply chain processes and to assess the potential impact of changes in RBC maximum storage duration on inventory management at both HAs. The methodology for modelling had been validated previously in its use to optimize inventory management to reduce ODRs at VCH [11]. Historical inventory data from 2017 to 2018 were used in the simulations to predict ODRs, the number of outdated RBC units and impacts on inventory management key quality indicators, including STAT order and non-group-specific RBC transfusion rates according to prospectively validated changes.…”