Implementation of a Redistribution System for Near-Outdate Red Blood Cell Units

Abstract

Context.—Many remote hospitals keep small on-site stocks of red blood cell (RBC) units for emergency use and to support patient care programs. In Canada, the blood supplier does not accept returned units into inventory. Discard rates can, therefore, be high. Objective.—To transport near-outdate RBC units to a high-usage hospital site, which would reduce overall discard rates, thereby increasing overall stock levels available in the blood system. Design.—A blood transportation system was developed and validated. The validation was presented to a high-usage site that agreed to accept near-outdate RBC units transported by this system. Stocks at the remote hospitals were optimized without increasing system-wide discard rates. The redistribution program was implemented in 4 remote sites in northern Alberta, Canada. The final disposition of each transported unit was tracked. Data from the first 2 years were analyzed. Results.—Between April 1, 2003, and March 31, 2005, 106 RBC units were successfully transported to and transfused at the high-usage site. The majority of the units were group O. None of the transfused units were involved in any reported transfusion reactions. The success rate of the transportation system varied among the sites (59%–78% successfully transported and transfused). Changes to the transport system were implemented as problems were discovered. The use of a temperature monitor in each shipment allowed for concurrent revalidation after each change. Conclusions.—Redistribution systems can be an effective way to reduce RBC unit discard rates. Even simple transportation systems have many factors affecting the RBC unit temperature. Novel temperature stabilizing materials may make future transportation of RBC units more reliable.

Blood Supply Chain Management and Future Research Opportunities

“…Pierskalla and Roach (1972) proves that FIFO minimizes cumulated outdates and shortages for some particular classes of perishable inventory problems. • Inventory Allocation and Distribution Policies: These models focus on allocating blood from a regional blood center to the hospitals considering the shortages and outdates (Abbott et al 1978;Denesiuk et al 2006;Elston and Pickrel 1965;Gregor et al 1982;Jennings 1968;Pegels et al 1977;Prastacos 1978Prastacos , 1981Sapountzis 1984Sapountzis , 1989Yahnke et al 1972;Yen 1975), and designing corresponding distribution schedules (Alshamrani et al 2007;Federgruen et al 1986;Hemmelmayr et al 2009Hemmelmayr et al , 2010Or and Pierskalla 1979). For example, Hemmelmayr et al (2009) investigate the value of switching from current vendee managed inventory to vendor managed inventory in the presence of a deterministic usage rate.…”

Using simulation to evaluate a blood supply network in the Canadian maritime provinces

“…A third model is used to allocate mobile delivery vans to service regions. Denesiuk et al (2006) provide a practical example of supply-chain integration. They describe the design and implementation of a transportation process to redistribute near-outdate RBCs from four remote hospitals in northern Alberta to a larger regional facility and report lower overall system outdate rates after implementing a transhipment policy.…”

Supply chain management of blood products: A literature review

“…They describe their system as a walking blood bank and appear to achieve satisfactory results using it. Denesiuk et al (30) discuss the implementation of a redistribution system for near-outdate red blood cell units. The paper considers both information about the transportation material and the method that is used.…”