session 2 different approaches to bsm - edqm · 1 edqm symposium blood supply management 1 october...

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EDQM SYMPOSIUM

Blood Supply Management

1 October 2012Strasbourg, France

Session 2

Different Approaches to BSM

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1www.veripalvelu.fi1

1www.veripalvelu.fi 1www.veripalvelu.fi 1www.bloodservice.fi

Blood Supply Management in Finland

Jarno AlénFinnish Red Cross Blood Service

EDQM SYMPOSIUM Blood Supply Management 1-2 October 2012, Strasbourg, France

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2www.veripalvelu.fi 2www.veripalvelu.fi 2www.veripalvelu.fi

We create potential for saving lives● Blood components to hospitals ● Clinical laboratory services ●Antenatal blood group determination ● Tissue compatibility tests ●Stem cell transplants ● Tissue services ● Pharmaceutical distribution ● Research and development

154,000 269,000 55,000donors > blood donations > patients

Blood Service in Brief● 540 employees ● 18 permanent locations and mobile services● A non-profit organisation ● 70 million euros in turnover

Only national supplier with over60 years history

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3www.veripalvelu.fi 3www.veripalvelu.fi 3

General organisation of Blood Supply Management

www.veripalvelu.fi

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Products and donations 1984-2011

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WB RBC Platelets (units) FFP WB donations Apheresis

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Planning and maintain of RBC inventory

• RBC inventory aim is based to 5 weeks average distribution. Aim is 7 days distribution per blood group– Monday minimum = 2 days distribution

• Every Monday blood situation meeting is placed where plans for following week are made. In meeting blood collection, production / distribution and communication are present. Minutes are distributed widely in organization.

• To get overall situation from RBC stock we use simple excel sheet where whole RBC situation is collected (manually filled)

www.veripalvelu.fi

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• RBC suffiency in days• In stock• In production• Aim• Over / under suffiency• RBC distribution yesterday /

site• Yesterdays blood collection• Whole weeks data

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RBC stock suffiency in days

www.veripalvelu.fi

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10.4.2012

16.4.2012

23.4.2012

30.4.2012

7.5.2012

14.5.2012

21.5.2012

28.5.2012

4.6.2012

11.6.2012

18.6.2012

25.6.2012

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9.7.2012

16.7.2012

23.7.2012

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17.9.2012

RBC stock suffiency in days, (A pos ja O neg separate )

Ylivarasto, yli 6 päivää tavoitetaso 4‐6 päivää Alivarasto, alle 4 päivää A Pos O Neg

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Strenghts• Centralized blood collection management, forecasting and

planning• Strong routine to forecast distribution in different time frames • Strong invitation process with SMS’s, Post cards, emails, news

letters, questionnaires and donor letters, facebook• Modern tools to follow and segment blood donation actions

with corporate management tools but (weakness)• Centralized blood inventory-, production management and

centralized ordering Centre which covers all customers in blood and pharmacy products

• Access to hospital inventories (covers 60% of hospitals)• Automated replenishment process to hospitals in RBC and

Octaplas products (60%) equalize days• Strong, fast and cost-effective logistic system which covers

whole country (in WB and component transportation)

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Automated hospital inventoryreports

www.veripalvelu.fi

Estimated duration of RBC stock in average usageand current size of RBCinventory. Access to data isvia Intranet.

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Weaknesses

• CPM tool we can segment easily but at the moment no automated system to contact wanted donor segments

• Commitment of blood donors to donate two times per year on going project

• Not very flexible process to balance collection in monthly and daily level in consumption spikes ones collection plans are made– Fluctuation in yearly and monthly level is not so high but daily

distribution fluctuation is quite significant (platelets)

www.veripalvelu.fi

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Threats

• Changes in operational environment in hospitals will be see in blood establishment on delay

• Too much visibility in media donors will be saturated to blood service messages

• Donation motivation of new generation donors• Finnish population is getting older. Consumption will rise?

At the moment getting down.• Immigration challenges to get rare donors and rare

blood • New social medias ad hoc donor happenings

www.veripalvelu.fi

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Opportunities

• Lots of data from past. In developing projects opportunity to develop lighter processes with smaller risk

• Blood group based automated (pushing) donor contact system right donor on right time

• Opportunity to develop ABO based blood collection at the moment result are known after blood collection sessions

• Electronic web ordering tool for hospitals more automated processes

www.veripalvelu.fi

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General organisation of blood supply management

www.veripalvelu.fi

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Conclusions

• Highly centralized system in all BSM areas

• Automated replenishment system for most customers

• Access to most customers RBC levels

• RBC and platelet future consumption tendency unsure in Finland

www.veripalvelu.fi

29/10/2012

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BLOOD SUPPLY MANAGEMENT

IN ROMANIA

Assist. Prof. Olivia Ligia Burta MD PhD,Blood Transfusion Center, Oradea, Romania

EDQM SYMPOSIUM Blood Supply Management1-2 October 2012, Strasbourg, France

General Organization of Transfusion Network

>BEs (41) + BE of Armed Forces>Public system>100% VNRD>”Performance competition “(RoMH proposes 3 categories of BE, according to performance criteria)>Non-accredited (SOPs implemented; Eubis)>6 BEs (20%) possess personalized softwear

>228 (of 463) hospitals perform transfusion activity:

58 Emergency Hospitals>Mainly state system (no reimbursement

of blood and blood components use)>Private system (payment for blood and

blood products use)> Most on-going accreditation, few

accredited (all with SOPs implemented)>~ 60% possess computer network

(most do not cover the HBB)

Blood Donor Management Patient Blood Management

Romanian Ministry of Health (RoMH)

Blood Management

29/10/2012

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The Actors and Reported Data in Transfusion Field; year of reference 2011

Health Status(blood donors/BEs)RBC donated units:

392,730

21 million people

Different Pathologies

(transfusion recipients)

15,562 (3.8%)discarded

570,516 units requested

377,170 units delivered

total n0

of donated units 398,993 190/00

n0 of supplied RBC 377,170 17.90/00

RBC

Meet of demand

66%

Platelets 52.0%

FFP 96.0%

Factor VIII 41%

General Organization of Blood Supply Management; the No-computerized System

Blood Donation Management (86% of BEs)

BEs

Daily Reports

Monthly Reports

Annual Reports

Trimester Reports

Semester Reports

Hospital Blood Management (~70%* of the H)

1.Daily manual

registration

2. Transferred into excel program

3. Sent to a secure e-mail

address (regulations)

Initial Flow-work

H

HBB

Daily Records

Monthly Reports

Semester Reports

Annual Reports

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General Organization of Blood Supply Management; No-computerized SystemBlood Donation Management

BEs

Daily Records/Reports

Monthly Reports

Trimester Reports

Semester Reports

Annual Reports

Financial reports [0]

Input/output reports [0] Daily stock (300 pm)to [1] (secure e‐mail: www.transfuzia.com raportari livrarects+countycode)

[1] National Institute of TM

Medical reports [0]

*Medical reports to [1] & [2] secure mails

[2] Public Health Authority

Medical reports to [1] secure mail

Medical reports to [1] &[2] [3] [4] by

chain of secure mails

[3] National Center for Public Health Statistics and Informatics

[4] National Institute for Statistics and Informatics

On the web-sites of [1], [2], [3], [4] – no information about transfusion data reported

[0] BEs Internal documents

*on‐going up‐date of medical report skeleton

Medical reports to [1] secure mail

Activity reports to [1] forecast ‐ National

tender secure mails

General Organization of Blood Supply Management; Blood Hospital Management the No-computerized System, often in Computerized System, as well

H

HBB*

Daily Records

Monthly Reports

Semester Reports

Annual Reports

[1]Hospital Statistic Department

[2]Hospital Financial Department

[0] HBB Internal Documents

[4]Public Health Authority

[5] National Center for Public Health Statistics and Informatics

[6] National Institute for Statistics and Informatics

Input/output rec. [0]

Delivered RBC volumes rec. [0]

Delivered n0 of RBC rec. [0]

*The reports are the Hospital Transfusion and Hemovigilance

Coordinator’s responsability

Medical rep. (standardized) to [4] [5] [6] secure mail

Delivered n0 of RBC rep. to [1][3] secure mail

Input/output rep. to [1] & [3] secure mail

Delivered RBC volumes rep. to [2][3] secure mail

[3]Blood Transfusion Establishment

Hemovigilance rep. to [3]&[4] (started in 2010) secure mail

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BEs

Daily Records/Reports

Monthly Reports

Trimester Reports

Semester Reports

Annual Reports

Daily stock (300 pm)

National Institute of TM (NIMT)

Medical rep.‐ NITM

Public Health Authority (PHA)

Medical rep. ‐ PHA

National Center for Public Health Statistics and Informatics (RoMH)

BEs Internal docs

HHBB

Daily Records

Monthly Reports

Semester Reports

Annual Reports

Hospital Financial/Statistics Dept.

Blood Transfusion Establishment

HBB Internal Docs

Input/output rep.

Hemovigilance rep.

Delivered n0 / vol of RBC rep.

Institutions/departments Basic documents

National Institute for Statistics and Informatics

1. Sagital approach (overlap)

Activity rep. – NITM forecast ‐ National tender

H/HBB

•BEs

Daily rec

•Daily rec/rep

Monthly rep

•Monthly rep

•Trimester rep

Semester rep

•Semester rep

Annual rep

•Annual rep



Public Health Authority

HBB Internal documents

Input/output rec

Delivered n0 /vol of RBC rec

Input/output rec

Delivered n0 /vol of RBC rec

Hospital

Blood Transfusion Establishment

Public Health Authority

National Institute of TM

BEs Internal documents

Daily stock (300 pm)

2. Lateral approach



Hemovigilance rep

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“7.11 Blood collecting and preserving, in the units with state majority ownership”

Years Blood transfusion centers(number)

Collected blood

(volume)

Transfused patients(number)

Transfused patients blood and plasma

(liters)

2005 41 180960 200132 144235

2006 41 144736 193456 139671

2007 41 157775 195304 148421

2008 41 156658 214020 146846

2009 41 193919 199000 168881

2010 41 184116 211621 153390

Yearbook of NATIONAL INSTITUTE OF STATISTICS, I.S.S.N.: 1220 - 3246, 2011

Total number of pages: 656 pages23 ChaptersChapter 7: Health (19 pages)

About transfusion activity, the following information:

The hospitals should increase the level of

quality in transfusion medicine

Lack of National Computerized Network at BEs

level

Weaknesses

No “e” interface: HBB/BEs

Gap between the 2 main

“actors”: pre‐hospital & hospital

Degree of in

fluence

Limited uniformity/

complementarity in reported data by the “actors” Limited Promotion

of Transfusion field, due to insufficient information displayed on

professional web‐sites

29/10/2012

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threats

Inadequate number/category of medical staff(no Transfusion

Medicine specialization)

Under‐financing the transfusion network

Degree of in

fluenceA continuous

overload of job description increase the risk of

human errors

Limited efficiency in collaboration/ coordination between interested

stakeholdersLack of medium and long‐term

strategic vision in both

“actors”

Incapacity to get to

European Standards in BSM and

hemovigilence system

opportunities

European funds for IT‐system (on‐going an

application for 4 BEs)

Editing specific manuals/guides/regulat

ions

(on‐going the Ethical Guide in Transfusion Medicine conception‐ready for publishing in

March 2013 )To use the

information from activity report for national tender, as a basic tool

for BSM

Post‐graduate Quality Management in

Transfusion training program (CME) for

each “actor” according to level of involvement, organized by medical

universities /professional bodies/experts

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To get political support in order to find financial resources to achieve theEuropean Standards in IT‐based BSM & Hemovigilence System, to implementNAT platforms, to develop plasma‐fractionation activity

• To be established the thresholds in each type of transfusion product inboth pre‐hospital and hospital level (regulations)

Periodic training (The RBC unmet demands vs the lack of any complain fromhospitals /fatal evolution, or life‐threatening condition due to absence oftransfusion products/ prove the “over‐ordering” policy of transfusionprescribers)

• All experts and stakeholders to be active parts in national commissions,permanent involved for developing the medium and long term strategyin transfusion medicine, in alignment of Romanian legislation toEuropean one [e.g. authorization of documents for transfusion networkreorganization based on performance criteria, import/export oftransfusion products (on going procedure) ]

To enlarge the reporting data in order a have a more complete and realisticview about general population health status (e.g. RBC inventory days/ RBCdestinated to autotransfusion, reasons of donors’ rejection..)

Conclusions. In order to achieve the National Policy objectives, about the assurance of an equivalent level of quality and safety, at each stage along transfusion medicine:

Acknowledgements

Marie-Emmanuelle Behr-Gross - TS 003 EDQM member

Gilles Follea - TS 003 EDQM member

Wim de Kort - TS 003 EDQM member , and to all the other members of the group

Alina Dobrota – Romanian Expert

Simona Parvu – Romanian Ministry of Health

29/10/2012

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12/10/2012

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Blood Supply ManagementIn Spain

MIGUEL ANGEL VESGA CARASACentro Vasco de Transfusión y Tejidos Humanos. Bilbao

EDQM SYMPOSIUM Blood Supply Management

1-2 October 2012, Strasbourg, France1

BLOOD LAW 1088/2005 Competent Authority Regional Governments(Regional Blood Transfusion Organisation)

Regional Health Service (17)

Blood Establishment (22)

Hospital Blood Transfusion Unit (381)

SPANISH BLOOD TRANSFUSION ORGANIZATION

BLOOD ESTABLISHMENT: Health establishment where each activity related to collection, qualification, processing, storage and distribution of blood and blood components are carried out no matter their final destination. The Director of a BE has to be a doctor specialized in Haematology and Blood Transfusion and a minimun experience of two years in a BE or Hospital Transfusion Service isrequired.

HOSPITAL TRANSFUSION UNIT: Healthcare unit inside a Hospital Center BOND to a BloodEstablishment , where, under the responsibility of a doctor specialized in Haematology and BloodTransfusion, blood componentes intended for transfusion are stored and hospital transfusionactivities are organised and monitored.

12/10/2012

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CENTROS DE TRANSFUSIÓN

1.803.765 voluntary and non remunerated blood donations

117,881

42.232 25.87298,029

29,732

46,535 291,257

102,651

187,091

54,198291,939

79,64648,401

260,669

11,729

68,945

46,958

SPANISH BLOOD TRANSFUSION ORGANIZATION2012

•RED CELLS PRODUCED

•RED CELLS TRANSFUSED

1000000

1100000

1200000

1300000

1400000

1500000

1600000

1700000

1800000

1999

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2002

2003

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Red Cells Self-Sufficiency : 100%

SPANISH BSM. STRENGTHS (1,2,5)

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01010101010101010202020202020202030303030303030304040404040404041111111111111111121212121212121220202020202020202121212121212121222222222222222223232323232323232424242424242424

RED CELLS TRANSFUSED RED CELLS ISSUED

BASQUE COUNTRY HOSPITALS SUPPLY / DEMAND 2005 - 2012

SPANISH BSM. STRENGTHS: 2,4

Red Cells Self-Sufficiency :100%

SPANISH BSM. STRENGTHS: 5

• HOSPITAL BLOOD BANKS WERE TRANSFORMED INTO REGIONAL BLOODESTABLISHMENTS (MOST OF B.E. WERE BUILT INSIDE OR CLOSE TO IMPORTANTHOSPITAL AREAS). A SIGNIFICANT PART OF THE HBB PERSONEL MOVED TO THE NEWORGANIZATIONS. THE HOSPITAL TRANSFUSION ACTIVITIES ARE ORGANISED ANDMONITORED BY THE DEPARTMENTS OF HAEMATOLOGY-HAEMOTHERAPY

• B.E. HAVE MAINTAINED AN EVIDENT CLINICAL ENVIRONMENT AND ATMOSPHERE

SPANISH NETWORK OF BLOOD ESTABLISHMENTS AND HOSPITAL TRANSFUSION SERVICES

•BE and HTS have to be licensed by theCompetent Authority

•Binding Solidarity

•Common Objectives

•Reciprocity

•Public Service

•National Blood Care and Sufficiency

BLOOD LAW 1088/2005

Blood Components Regional movement (2010):

•Red Cells: 35,899

(2% of Red Cells production)

12/10/2012

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INSPECTION OF B.E. AND H.T.S. / 2 YEARS.


OPTIMAL USE ACCREDITATIONPROGRAMME FOR B.E. AND H.T.S.

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•REGULAR DONORS

•NEW DONORS

VNRBD (Blood Law)


12/10/2012

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monthly collections profile

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RED CELLS INVENTORY WEEKLY MANAGEMENT AND SECURITY LEVELSSPANISH BSM. STRENGTHS:

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RED CELLS TRANSFUSEDRED CELLS REGIONAL GENERAL STOCKRED CELLS ENTERED INTO STOCKBLOOD DONATIONS

12/10/2012

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INFORMATION SYSTEMS (Blood Establishments):

•PROGESA: 43%

•e-DELPHYN: 24%

•HEMATOS: 19%

•NET-BANK GOLD: 14%

SPANISH NETWORK OF BLOOD ESTABLISHMENTS AND HOSPITAL TRANSFUSION UNITS: SHARED INFORMATION SYSTEMS

NO: 52.4%

YES: 47.6%

Regional

SPANISH BSM. STRENGHTS (4)

CATALUÑA:

•Hospital transfusion staff belong to the B.E. Personnel structure

BASQUE COUNTRY, RIOJA, ARAGÓN, GALICIA:

•Transfusion Network (B.E. + HBS) sharing a Common InformationSystem (Real Time) managed by the B.E.

•Benefits: Unique inventories management, patients relevantinformation and haemovigilance records are easily available,haemovigilance records, management of transfusion practicesmonitorisation…..,

Regional Transfusion Network Models

SPANISH BSM. STRENGHTS (4)

12/10/2012

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12/10/2012

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CENTROS DE TRANSFUSIÓN

BLOOD ESTABLISHMENTS

Blood Establishment

SPANISH BSM. WEAKNESSES

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A AB B O

BLOOD ESTABLISHMENT HOSPITAL SERVICES

EXPIRED RED CELLS

GRUPO RH AÑO

PLACE

EXPIRED RED CELLS: BE AND HOSPITALS

SPANISH BSM. WEAKNESSES :4

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RED CELLS UNITS PATIENTS

050010001500200025003000

RED CELLS UNITS PATIENTS

Red Cells Rh (+) Patients Rh (-)Red Cells Rh (-) Patients Rh (+)

2005

2012


12/10/2012

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AGE OF RH NEGATIVE RBC TRANSFUSED TO RH POSITIVE RECIPIENTS

AGE OF RBC Rh (-) ISSUED TO HOSPITALSvs

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ayor..

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Threats

ECONOMIC CRISIS: It might delay the strategies toimplement new information technologies aimed toimprove B.E. and H.T.S relationships.

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Opportunities

ECONOMIC CRISIS: It might speed up furthercentralization activities between different regional organizations

12/10/2012

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SPANISH BLOOD SYSTEM:

Red Cells Supply Management. Conclusions

1. REGIONAL AND NATIONAL RED CELLS SELF-SUFFICIENCY BASED ON VOLUNTARY AND NON REMUNERATED BLOOD DONATION

2. NATIONAL NETWORK OF BE AND HOSPITAL TRANSFUSION UNITS (PART OF THE NATIONAL HEALTH SERVICE) SHARING GOALS, WORK METHODS AND PRIORITIES

3. REGIONAL NETWORKS TREND: COMMON INFORMATION SYSTEMS INTENDED TO OPTIMISING THE BLOOD SUPPLY PROCESS, THE SAFETY OF RECIPIENTS AND STOCKS MANAGEMENT.

12/10/2012

1

Blood Supply ManagementIn Ireland

Paddy Bowler – Irish Blood Transfusion Service


1‐2 October 2012, Strasbourg, France

Reminder: the BSM Process Model

1. Assess past hospital RBC use for patients2. Establish Forecast for overall annual supply (for BEs) and use

(for hospitals)3. BEs: Establish annual Blood Collection/Donor base/Supply

Programme 4. Weekly balancing WB/RBC use (demand) and supply in

BE(s)/RBC supplier(s) and Hospitals – Monitoring inventories: Use, Collection outcomes, Estimated losses– Acting to maintain / replenish inventories at adequate levels– Preventing shortage / excess if inventories predicted “out of range”

5. Assessing and updating the patients’ RBC needs and their satisfaction (self‐sufficiency / partial sufficiency / oversufficiency) from VNRBD (%)

– Acting when partial sufficiency / oversufficiency / < 100% VNRBD

12/10/2012

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General organisation of blood supply management

Strengths: steps 1 ‐ 4

• National BE: 100% supplier , with 5 yrs historical data of demand by hospital by component – 140,000 red cells issued p.a.

• Forecasting process (BE) fully automated• Good interaction BSM – donor management• Good collections prediction accuracy at blood group level (3‐5% per week)

• Losses by category well understood• BE stock levels by component accurate and easy to access

12/10/2012

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A simple forecasting tool (Excel)Balancing Demand/Supply– 5 components

1. Stock at the start of a forecasting period

2. Estimated demand

3. Collections’ plan: Donor attendance & expected units / types collected

4. Estimated losses

5. Stock at the end of a forecasting period

Forecasting Model – from information available within the BE

A ‐ CURRENT STOCK = ?

B ‐ ISSUES THIS WEEK = ?

C ‐ COLLECTION TARGET THIS WEEK = ?

D – LOSSES % (collection, process, test, quality) = ?

E ‐ STOCK NEXT MONDAY = ?

E = (A + (C*(1‐D)) ‐B

12/10/2012

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IBTS Forecasting Process Output

“Hyperlink to main spreadsheet”

RBC Supply Forecast

0.0

2.0

4.0

6.0

8.0

10.0

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14.0

16.0

15/0

8/201

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Week

Starting

Days

Supply

O+ A+ B+

O‐ A‐ B‐

Interaction BSM – donor management: supply levers

• SMS to donors– Partnership with Vodafone since 2004 including free SMS ‐ 1.2M p.a.– Irish are among highest users of SMS per capita world – 2800

/person/week– Donors receive collection session SMS– Additional text messaging used to switch on/off at blood group level– Telerecruitment where necessary on Rhesus negative

• Group Specific Text MessageTemplates (Max ‐ 162 characters)– You are 1 of 35 A ‐ donors in Tipperary. We URGENTLY need at least 25 A ‐

donations in Tipperary tonight to increase stocks of A‐ blood. Thanks from IBTS.

– Your blood group is AB+ As AB+ stock is currently 10 days please skip donating in Limerick this time & we hope to see you there next time. Thank you IBTS

12/10/2012

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Impact of SMS on Blood Supply

November 2006 O Positive Text Analysis

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29/10/2006 05/11/2006 12/11/2006 19/11/2006 26/11/2006 03/12/2006 10/12/2006 17/12/2006

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Total Receipts + Transfers

Stock on first day of week

Texts sent per week

Weaknesses: steps 4 ‐ 5

• Poor visibility of hospital stocks

• Hospitals have a weak view of their own demand drivers

• Lack of a formal hospital liaison function

12/10/2012

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Threats: steps 1 ‐ 5• Lose visibility at hospital level as new trusts are established in a restructured Irish health system

• Restructured health system will promote competition – money follows patient

• Donor messaging fatigue – O neg

• Donor base attrition as donor wellness agenda develops

Opportunities: steps 2 ‐ 4• Interaction BSM ‐ Donor management

– Introduce donor appointments to assist collection projections

– Collecting donor e‐mail addresses for more targeted marketing

– “Blood Buddies” marketing campaign to raise donor’s awareness of their blood group

• Establish a hospital liaison function

• Using a web based system to allow hospitals order –allows IBTS capture true demand and develop service performance metrics

12/10/2012

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Conclusions

– Highly automated & validated forecasting process with good level of organisational confidence

– Well proven supply levers – Rhesus negative particularly

– Poor visibility of hospital stock levels

12/10/2012

1

Blood Supply ManagementIn Portugal

Mario Muon

Portuguese Blood and Transplantation Institute


1‐2 October 2012, Strasbourg, France

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Blood Transfusion System in Portugal ‐ I

• Portugal has a mixed Blood Transfusion System based on the Portuguese Blood and Transplantation Institute (national blood policy) and Hospital Blood Transfusion Services

• 2/3 of the blood collection, testing, processing, storage and distribution are performed by the three Blood and Transplantation Centers: Lisbon, Porto and Coimbra

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Blood Transfusion System in Portugal ‐ II

• There are 80 hospital transfusion services.

• 23 are also blood establishment s as they collect, test, process and store blood and blood components.

• The majority of these BE/Transfusion Services (20) are not self‐sufficient and receive blood components from Blood Centers.

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the BSM Process Model

1. Assess past hospital RBC use for patients2. Establish Forecast for overall annual supply (for BEs) and

use (for hospitals)3. BEs: Establish annual Blood Collection/Donor base/Supply

Programme 4. Weekly balancing WB/RBC use (demand) and supply in

BE(s)/RBC supplier(s) and Hospitals – Monitoring inventories: Use, Collection outcomes, Estimated losses– Acting to maintain / replenish inventories at adequate levels– Preventing shortage / excess if inventories predicted “out of range”

5. Assessing and updating the patients’ RBC needs and their satisfaction (self‐sufficiency / partial sufficiency / oversufficiency) from VNRBD (%)

– Acting when partial sufficiency / oversufficiency / < 100% VNRBD

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General organisation of blood supply management ‐ Portugal

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Plan

Anual collection planning

Hospitals blood Use data

BE blood Supplied data

MonthlyPlanning

confirmation

Monthlyplanningexecution

Daily web based Monitoring

BE+Hospitalsinventory/use

Collection

Add/Reducecollection

BSM Process Model in Portugal ‐ I

1. Assess past hospital RBC use for patientsAssess past RBC supplied by IPST for hospitals

2. Establish Forecast for overall annual supply3. Establish annual Blood Collection/Donor base/Supply

Programme

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BSM Process Model in Portugal ‐ II

4. Daily web based monitoring RBC use and inventories in BE(s)/RBC supplier(s) and Hospitals

– Monitoring inventories: Use, inventories and Collection outcomes – Acting to maintain / replenish inventories at adequate levels– Preventing shortage / excess if inventories predicted “out of range”

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BSM Process Model in Portugal ‐ III

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BSM Process Model in Portugal ‐ IV

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BSM Process Model in Portugal ‐ V

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Strengths: steps 4 &5

• BE s+ Hospitals inventory /supply/use web based Monitor system Bes and Hospitals access

• National average and minimun inventories established

• Hospitals BS audits

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Weaknesses: steps 4 &5

• Blood request/Blood supply/Blood use not clear

• Lack of Tx specialists/Tx committee/guidelines in BS for best pactice

• Private clinics not in the monitor system

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Threats: steps 3 & 5

• Public administration restructure

Health Ministery Blood Policy uncertainty

• Private blood suppliers

• Private blood collectors

• No pluriannual human resources planning

due to law

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Opportunities: steps 3 & 5

• Centralized promoting service for all country

• Centralized processing, testing and supply

• Unique identification number implementaion/consolidation

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Conclusions

Recommendation as good practice in BSM

– Monitoring system BE + Hospitals

– Centralised Processing + testing + distribution and promotion planning

– Unique identification number implementaion

– Hospitals average and minimun stock needs established

Not recommend as good practice in BSM

– Absence of annual planning

– Hospitals over stockage

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