Inventory management strategies that reduce the age of red blood cell components at the time of transfusion

Abstract

Inventory age depends on active management, combined with vendor cooperation to receive fresher components. Reducing the age of RBC components transfused is possible without experiencing blood component shortages. Longer periods of observation may allow for further adjustment of stocking levels on a seasonal basis.

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

“…Though RBC storage duration has been used in the past, we emphasize its operational rather than clinical value of preventing harm by providing fresher blood , given evidence from randomized controlled trials that transfusion of RBCs with increased storage duration has not been shown to cause patient harm . Our approach does not consider clinical blood bank practice, such as fluctuations in unit allocation due to clinician practice patterns or RBC discard rates that are not due to outdating .…”

“…To aid in this inventory planning role, two strategies can be used, including (1) transfusing RBC units that are closer to expiry to patients with compatible but mismatched (or non‐identical) ABO blood groups; and (2) participating in blood redistribution programs where larger hospitals act as hubs to receive older in‐date blood units to minimize regional blood wastage . Previous literature also describes successful approaches to improvement in inventory management to reduce the likelihood of blood wastage and to increase the volume of fresher RBC transfusion in hospitals .…”

“…Considering other approaches that emphasize multiple complementary objectives may add further value to models to improve inventory management . Measures to improve efficiency using conventional KPIs lead to proportionally fresher blood transfused, suggesting that age of blood in the supply chain may be a complementary KPI which better reflects improved blood inventory management . Though the majority of studies on blood bank inventory optimization that deal with decreased age of blood transfused (ABT) focus on the prevention of adverse clinical effects from RBCs due to increased storage duration , recent randomized controlled trials have not supported the contention that increased ABT is linked to patient harm .…”

Modelling the blood bank inventory: simple formulae for stock management in clinical settings

“…Key performance indicators (KPI), such as waste as a percentage of issued units (WAPI) [4], issuable stock index (ISI) [5] and the blood-group specific average age of transfused units [6], are used to summarise inventory performance. Moreover, correlations are observed between KPIs: increased restock thresholds are associated with transfusion of older units [7] and higher levels of waste [5]; high levels of cross grouping can also be indicative of issues with inventory performance; and ISI and WAPI are positively correlated [5]).…”

“…restock frequency) [16]. The potential utility of such an approach in clinical settings is evident in a further study in which the proposed formulae are used to aid the reduction of restock levels so as to reduce the age of transfused units in the inventory [7]. However, as the proposed formulae are derived from heuristic arguments rather than first principles, the extent to which they are a complete description of how fundamental processes (ageing, supply and demand) give rise to observables (e.g.…”