Improving Supply Chain Performance Of Blood Services

Improving Supply Chain Performance Of descent service consanguinity Banking proceedss is one of the most important operations worldwide. The declivity line confideing returns provides the resources for transfusion needed in e genuinely medical intervention, whether in peacetime or during war.This account observes the c ar for of origination banking preparation range of a function, starting with the upstream providers of rude material ( contrast) and down to the downriver consumers of harvestings (hospitals). In the first part of this paper we present an overview of the offer chain of prodigal banking, and inspection the relevant explore and literature regarding summate chain behavement of billet banking.In the indorsement part, we select both atomic number 18as of the supply chain and select key implementation indicators (KPIs) that observe the forest of the supply chain of phone line banking, from an aspect of service quality and speak to control. We ci rcumstances the catamenia take aims of these KPIs with relevant info if it is pronto available or by extrapolation from historic data where the current aims be unavailable.In the third part, we propose changes to the supply chain to improve the argonas of review. These overtures forget be indicated by changes in the selected KPIs.Analysis of supply chain deedCorpo deem OverviewCanadian race Services (CBS) is the national non-profit organization created to manage the railway line supply through unwrap Canada outside Quebec. Canadian kind inflammation Services operates 41 permanent collection sites and more(prenominal) than 20,000 donor clinics annually (Canadian alliance Services, 2009 British Columbia Ministry of Health Services, 2002).The main intersections of CBS are Red Blood Cells, Plasma protein harvest-tides, Platelets and Plasma for transfusion.In 2008 CBS salt a appearance 915,858 units of whole blood from 425,000 donors. CBS operate provides blood supply ser vices for a population approximately 26,201,377 (Statistics Canada, 2010).Blood Banking Process Overview of CBSThe overall form of blood supply is the following a given geographic region is serviced by a regional blood center ( red blood cell) and smaller community blood centers (CBCs). These are responsible for providing blood products to hospitals. To achieve this, the Blood Centers must plan donor collection at aforethought(ip) locations. Donors are invited to donate blood to donor clinics. To reach a wider donor population, mobile collection units (specialized vehicles) are sent to sites where at that place are no fixed donor clinics (Pierskalla, 2004.).Depending on the requirements for blood products, the whole blood are collected into appropriate bags are used when drawing blood. The collected whole blood is sent to a CBC or red blood cell for accomplishing. thither, it is tested for viruses and diseases, and final components are prepared from the whole blood. The compone nts are hardened into neckcloth for shipments to hospitals based on their blood product requirements. CBS operates only 41 permanent collection sites/RBC. The supply of blood products is then distributed to hospital blood centers, without community blood centers.The blood products are highly perishable, with shelf brio from 5 to 35 days. If a particular component exceeds its maximum shelf life sentence, it must be destroyed. This process is presented on the following figure.Current tail end of meeting demand is 95% of hospital demand nine months out of twelve.Literature review(Keal and Hebert, 2010) conclude that blood banks must reorganize their learning ability and adopt KPIs on a daily basis. Naturally, financial, operations and executive levels may be interested in a assorted set of indicators. Blood banks need to perform analysis with a much greater frequence then currently performed to become more elastic to demand and changing environment. As a first step, a blood bank need to identify which issues it demand to address when implementing KPIs.(Jennings, 1973)- Cooperation among is successful in outdate and shortage watchfulness is a unassailable choice. Common inventory policy between blood centers reduce the numnber of outdates and shortages by 72% in a 20 blood center cluster, and by 64% for a 5 blood center cluster. Simple threshold transfer policy reduce the numnber of outdates and shortages by 61% in a 20 blood center cluster, and by 54% for a 5 blood center cluster. This operates on a Outdate / Shortage ratio of 1.0 (equal number of shortages and outdates). Simple treshold transfer is much more efficient in conveying logistics and equals, as well up as information support systems.(Prastacos, 1984) Blood collection is through organized collections, invited donors and walk in donors. No donor should be returned. This variance in collection environemnt dictates actually careful selection of Optimal component processing policies to achieve optimum supply of proposed products. Donors react confirmingly to appointed advantage (rewards, altruism, health checks). The commanding reinforcement is a key conclusion of the research of (Oswalt, 1977).(Hemmelmayr et al., 2009)- Discusses that a Vendor-managed inventory (VMI) control for blood products shtup buoy be extremely efficient, including scenarios of multiple products.(Jones, 2003) Changes to mandate and public events can set about a remarkable dip in donations and give birth blood product shortages. These can be localized, and impact the different regions differently, thus testing the elasticity of the system. Donors react positively to positive reinforcement (rewards, altruism, health checks).The blood donor pool of necessity to be that researched, since significant number of potential donors are untapped.(Katsaliaki and Brailsford, 2007) performs a computer air model of the blood banking environment end-to-end and concludes that there are pat h for changes that will improve the overall system state. These changes include changes in argument planning, management of inventoryKey Performance Indicators, KPIs, are indicators showing what needs to be done in an internal operative perspective. These KPIs direction on the parts of an organisations performance that are the most unfavorable to success, twain for present time and future. A good KPI affects a number of critical success factors. It also affects different KPIs in a positive manner. Parmenter (2007, page 3)Due to Neely et al (2000), each connection has to map their way to success through identifying a number of key factors in the processWhen implementing KPIs, it is of utmost importance that goal measures for e really KPI are defined. Shahin and Mahbod (2007) claim that bruise goal setting is a commonly used set of criteria of how to set goals. SMART stands for Specific, Measurable, Achievable, Realistic and Time Sensitive.The service level is the ability for th e comp whatsoever to secure delivery to its nodes. When calculating the safety sprout the service level is used. (Mattsson, 2004, page 160)decrease the holding stock to 4 days, the introduction of 2 routine deliveries in working hours to cave in manage differentiates from the NBS and grouped transport to hospitals, a more insensitive ad-hoc battle arraying point for RBCs to 35% of the optimum stock level, the reduction of the heart and soul crossmatch release close ( in front and after transfusion) to 1 day, the increase of the transfusion to crossmatch ratio to 70%, either through stricter meekness with the recommended ordering system leading to more accurate orders placed by doctors, or by applyingm ultiple-crossmatchingte chniques, strict adherence of the hospital blood bank when cross-matching units to a FIFO order for units coming from the Centre and LIFO for the unused, returned units from the different wards. In other words, compliance with a FIFO order accordingt o the collection/productiond ate of the unitAnalysis of Key Performance Indicators of procuranceThe main challenge in the procurement process for blood banks is the supply of the source of all blood products donors who can vary since donors are volunteers. The supply is further impacted by the list of viruses and diseases that the donations need to be screened for before the products can be used for transfusions (Pierskalla, 2004.). All collected whole blood and blood products are stored in special containers bags that differ depending on the product they contain. A defective batch of containers delivered from the manufacturer will cause a recall and destruction of an entire batch of collected WBC or entire batches of products.The CBS procurement KPIs that will be investigated arePercent of RBC shipped vs whole blood collected This KPI will measure the ratio of of red blood cells shipped to the whole blood collected. From the collected blood, there can be discards due to a variet y of reasons (quality control, test results, post-donation information, equipment problems, process non-conformances). This ratio indicates the quality of blood collection and processing. CBS has an average of 79% ratio of this KPI over a 3 year period (Canadian Blood Services, 2009). amount of Blood product recalls per 10,000 collections This KPI measures the number of blood product recalls once they have been distributed to the hospitals that need to be recalled due to errors, accidents and post-donation information, for every 10,000 blood collections. This ratio is important to since it influences the overall customer satisfaction, and causes be for the reverse logistics. CBS had the worst recall ratio in 2008, with significant decrease in 2009 (Canadian Blood Services, 2009).Number of Whole blood donors A very straightforward KPI, which tracks the number of persons that donated whole blood the upstream suppliers. This KPI needs to be closely followed, since a declining numb er of donors indicate a very real risk of blood and product shortages since the upstream supply is reducing. CBS historical data for this KPI indicates a varying trend in the past 3 years (Canadian Blood Services, 2009).Number of Units of whole blood collected vs Number of Whole blood donors This KPI presents the prolificacy of each donor during the year. The average time lag period between donations for a donor is 70 days. This means that at most, a single donor can make 5 donations per year. CBS has this KPI at a very ceaseless 2.17 over the 3 year period (Canadian Blood Services, 2009).Number of blood containers defective per 10,000 units collected- Since the blood procurement process is extremely dependent on the correct and good quality containers bags. Therefore, a KPI is needed to identify the amount of defective containers, and properly manage the supplier relationship with the suppliers of these containers. CBS has seen the most defective bags are noted in 2008, with a d eclining trend in 2009.Analysis of Key Performance Indicators of schedule solicitudeAs (Jennings, 1973) concludes, three of the most important measures in inventory management in any blood bank are shortage, outdating and cost. We will review the following KPIs in the CBS modelNumber of component indate discards over components produced The cast aside components from inventory within their shelf life are part of the derive loss of stock. Recalls for any reasons, as well as defective containers cause indate discards. But indate discards from inventory reduces available inventory, and can impact the carefully planned balance of procurement, stock and distribution. CBS has a trend of reduction of indate discards in stock, which is logical with the increase percentage of delivery of products to collected blood units.Number of overage components to total components in inventory Since blood products are extremely perishable, there is no opportunity to keep a stock of blood product s for any long period of time unless they are cryofrozen (out of scope of this paper). The outdated components are the stock of products that have not been used before their shelf life has passed. This KPI is crucial in track the expiry of products (and conversely money) due to unfortunate planning. CBS is reducing the outdated products and bringing it to 2.5% at an annual level.Cost per blood product unit shipped Since everything is about cost reduction or customer support, this ratio is crucial for cost management. Every step in the blood banking process is very expensive, and the tracking of this KPI is important for top management, as well as the logistics manager. As can be seen in the diagram, this KPI for CBS is showing increasing costs (Canadian Blood Services, 2009 British Columbia Ministry of Health Services, 2002)Percent of revise fill rate, by blood product type This KPI directly tracks the downstream supply chain service quality. The percent of order fill rate is i n essence the achieved service level for each type of product. total blood requests, by type of blood product (red blood cells, platelets etc.). CBS sees a reduction of the service level for order fulfillment in the 3 year period (Canadian Blood Services, 2009).Proposed Changes for Improving PerformanceAfter reviewing the KPIs of the two processes of interest, certain trends are identified that need to be analyzed and curative action be taken. Each of these KPIs will require a logistic effort.ProcurementThe procurement process of Blood Banking supply chain was ascertained through 5 KPIs and it was identified that 3 are indicating positive trend. The other 2 KPIs are indicating negative trends that need to be treatincrease units of whole blood collected per donor, which indicates reduced motivation of the supply sources. The positive donor motivation should be returned only through positive reinforcement. (Prastacos, 1984 Oswalt, 1977). In logistics terms this would mean more equip ment, benignant resources, marketing material and constant communication with donor relationship teams to provide necessary resources.Number of blood containers defective is widely varying. Most organisations monitor their suppliers to make sure that they restrain to give satisfactory service. This is called supplier place or vendor rating (Waters, 2003) Multiple suppliers and very frequent tracking of this KPI (weekly level) (Keal and Hebert, 2010) so proper remedial action can be taken . FIFO/LIFO blood ManagementThe inventory management process of Blood Banking supply chain was observed through 4 KPIs. While 2 KPIs indicate good trends and successful operation, the other 2 indicate serious issues that need to be remedied. The main actions that need to be taken from the investigated KPIs areIncreasing order fill rate. The following diagram presents the overall service level of CBS for order fill rate. It can be concluded that the overall service level (product of service levels of the three products) is steadily declining.The safety stock needs to be increased on all three products to include (Ballou, 2004 Waters, 2003)Trans-Shipment for grouped expect Centers (Jennings, 1973) and re-use of returned indate products (Katsaliaki and Brailsford, 2007)Vendor Managed Inventory for hospitals (Hemmelmayr et al., 2009)Controlling cost per blood product unit. There is a consistent trend of increasing cost of blood product unit. The cost breakdown in Appendix C shows that the major cost elements are the blood collections and distribution, consisting of 50% of all costs (excluding administration). Since the best positions for cost reduction are at the point of contact between supply chain partners (Waters, 2003), these exact points should be investigated for cost reduction.ConclusionBlood Banking is direct the supply of a key component of life blood and bood products. It is considered a crucial service for any country, and is even treated as a big business in som e countries.The logistical issues of blood banking are many on every level, since blood banking must achieve very fast delivery of products, and any stock-outs may mean loss of human life. This is furtherThrough adoption of KPI tracking throughout the processes of blood banking, a blood service like Canadian Blood Services (CBS) can achieve a very quick reaction time to indecorous indications of deficiencies in the process.The procurement process has logistical issues that need to be followed by the logistician in the area of donor treatment, which is an activity that will be performed in coordination with Marketing. A more pressing issue is the management and tracking of quality of blood containers and their suppliers, since a faulty series of containers will cause product recalls, stock-outs and financial losses.The inventory management process as a first priority must focus on achieving an much better overall service level of order fill rate than the current one. The service lev el needs to be increased by a higher safety stock, but since only increasing the safety stock is costly, a trans-shipment of products between centers need to be performed. Also, this service level can be improved by agreeing on a Vendor Managed Inventory with the hospitals. The other issue is cost of blood product management, through optimizing the process which requires most logistics blood collections. An optimized process of blood collections which can reduce costs of that process by 10% will show significant improvement of the cost of blood product.