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The Production and Supply Chain
 Management of Kuwait Central
 Blood Bank against Disastrous
             Times



          Dr. Raed Al-Husain
  Department of Quantitative Methods
       and Information Systems
          Kuwait University
Facts
• According to World
  Health Organization
  (WHO) (2011), while the
  need for secure supply of
  blood continues to
  grow, more than 70
  countries lack the
  necessary rate of blood
  donation in order to meet
  their required
  demand, and many
  patients die due to
  shortages in blood supply.
Facts
• News Medical (2010)
  reported that a study
  conducted on hospitals
  in the U.S. and
  Europe, that annual
  expenditures on blood
  and transfusion for
  surgical patients costs
  $1.6 to $6.0 million per
  hospital, 37% higher
  than estimated by prior
  studies.
Facts
• Nationwide Blood
  Collection and Utilization
  Survey Report (2007)
  stated that 4.5
  million Americans will
  need blood transfusion
  each year, yet only 37
  percent of the U.S.
  population is eligible to
  donate blood and less
  than 10% do annually.
Facts
• A study by Cant (2006) stated that in 2001, 7%
  of U.S. hospitals had to postpone surgeries
  due to shortages in blood inventories.
• A survey study conducted by Toner (2011)in
  the U.S., states that the cost of
  acquisition, screening, and transfusion of
  blood had increased over the past 5 years due
  to blood shortages.
Facts
• In order to cope with its
  increasing cost and
  instability of
  supply, effective and
  efficient supply chain
  practices of blood is
  essential to ensure
  blood transfusion
  procedures for those in
  need.
Blood Basics
• Blood banks fractionate the whole blood in to
  different components:
  – Cryoprecipitate (Cryo):
     • prepared from Plasma and be kept Frozen and has a
       shelf life of up to one year.
  – White blood cells (leukocytes):
     • Transfusion is rare and can last from 18 – 36 hours.
  – Red blood cells (RBC):
     • Most common in the blood and has a shelf life of about
       35 days.
Blood Basics
– Platelets:
   • They cannot be refrigerated or frozen as they will be
     destroyed, which make them very valuable product and
     require extra care when dealt
   • Platelets have a shelf life of 5 days only.
– Plasma:
   • It has shelf life of up to 2 years and can be frozen.
– Fresh frozen plasma (FFP):
   • very similar to plasma's content except that it is
     prepared and frozen at -18 C○ or colder within 8 hours
     from donation time, whereas plasma is frozen within 24
     hours of donation time.
Blood Basics
• Blood types are divided
  into different groups
  referred to as the ABO
  groups.
• There are 8 different
  ABO group types
Blood Basics
• The most common blood types are O+ and
  A+, but they are also the types that cause the
  most concern.
• Many potential donors with these types of
  blood are reluctant to donate thinking that
  their blood is not needed much, where in
  reality their blood type is really used more
  than twice as much as any other types.
Blood Basics
• The rarest type is AB-.
• It has been estimated that only about 1 in 170
  people have this type.
• Next most rare blood type is the B-, About 1 in
  every 70 people has this type.
Blood Supply Chain
Blood Supply Chain
• Donation Process:
   – It starts with a volunteer
     donor who gives a unit of
     417ml of blood cells.
   – The blood donation
     process could take place
     either at a local blood
     bank, or at a different
     blood donation sites.
   – The donated blood is then
     transferred to the nearest
     processing center, or any
     alternative center in case
     of overflow or emergency
     demand.
Blood Supply Chain
• Blood Processing:
   – At the processing center a
     blood unit is tested and
     processed into different
     components.
   – After the testing is being
     completed and the blood
     cell unit is being
     approved, it is then
     transferred to a hospital in
     need, either based on a
     schedule or an emergency
     requisition.
Blood Supply Chain
• Blood Transfusion at
  Hospitals:
   – A blood bank within the
     hospital then makes that
     blood available to a patient
     and eventually transfused.
   – A blood unit that is
     crossmatched for transfusion
     and labeled as assigned
     inventory but not used, is
     returned to the hospital's
     unassigned inventory.
   – An excess in blood inventory
     at a local hospital could be
     returned to a processing
     center where it is reallocated
     again to different hospitals.
Major Issues of Blood SC
• Wastage of blood
  components:
   – For RBCs, wastage can be
     caused due to time expiry and
     out of temperature control
     due to refrigerator failure.
   – For platelets, over 95% of
     wastage is due to time expiry
     either within the blood
     processing center or the
     hospital as well, in which they
     are ordered for surgical
     purposes but then fail to be
     transfused; hence unable to
     be returned to the blood
     processing center or allocated
     for another patient.
Major Issues of Blood SC
• Transfusion mismatch:
  – Caused from patients
    receiving the wrong
    blood type.
  – Although it is rare, it
    remains an important
    cause of mortality.
Major Issues of Blood SC
• Blood shortages:
  – Blood shortages
    normally occur in areas
    where disasters strike.
  – Another reason for the
    blood shortage include
    increased use of blood
    for more advanced
    procedures than blood
    transfusion.
Major Issues of Blood SC
• Collaboration between
  all various elements of
  the supply chain:
   – Caused by the lack of data
     sharing of supply chain
     players (donation
     centers, processing
     centers, and hospitals).
   – Lack of horizontal visibility
     at the end of the supply
     chain.
   – Hospitals are usually
     individually responsible for
     the fate of the blood.
Literature Review
• The interest in the
  management of blood
  banks services dates
  back to the early 1960s.
• However, only most
  recent work will be
  discussed here.
Literature Review
• Angelis et al. (2001) developed a goal
  programming model with multi-product and
  multi-period to determine the best
  assignment of blood resources to demand.
• The objective of their model is to minimize
  the quantity of blood imported from outside
  the system and stabilize the quantities
  assigned daily.
Literature Review
• Kozan (2001) developed a stochastic model that
  simulates the blood bank inventory system of a
  hospital over a finite number of days.
• The study examined the influence of mean and
  variation of daily transfusion, the remaining shelf
  life of blood units shipped from the blood
  supplier, and the number of days between
  consecutive shipments on blood outdates and
  shortages.
Literature Review
• Blake et al. (2003) developed a dynamic
  programming model to determine local
  inventory ordering policies for platelet
  suppliers.
• Bosnes et al. (2005) used regression analysis
  in order to predict the daily number of blood
  donors arrival in peruse to minimize the
  waiting time in blood donation centers.
Literature Review
• Katsaliaki and Brailsford (2007) conducted a case
  study on a UK hospital blood inventory system.
• A simulation model was used to monitor the
  entire supply chain of blood, from donor to
  recipient.
• Their objective was to determine an ordering
  policy that will lead to the reduction in blood
  shortages and wastages, increased service
  levels, improved safety procedures, and reduced
  costs.
Literature Review
• A similar study was conducted by Jennings
  (2009), where a detailed inventory model of a
  hospital blood bank was developed using
  simulation.
• The main objective was to study the effect of
  the hospital's inventory policies on blood
  shortages and blood outdates.
Kuwait Central Blood Bank
                  (KCBB)
• KCBB is the major blood
  provider in Kuwait for both
  governmental and privet
  hospitals.
• The blood supply chain
  network of KCBB is very
  similar to the general
  network shown earlier.
• However, the unused blood
  units at hospitals are kept in
  their local blood bank
  inventory and not returned
  back to KCBB.
Kuwait Central Blood Bank
                 (KCBB)
• KCBB produces 6 types of blood components:
  1.   Leukocyte reduced RBCs (LR-RBCs)
  2.    Leukocyte reduced FFP (LR-FFP)
  3.    Cryo-depleted plasma (Plasma)
  4.   Cryoprecipitate (Cryo)
  5.   Apheresis FFP (APH-FFP)
  6.   Platelet Apheresis (PC-APH)
Kuwait Central Blood Bank
         (KCBB)
Kuwait Central Blood Bank
                (KCBB)
• The production process at KCBB includes the
  following stages:
  – Registration and donation
  – Testing and processing
  – Storing and delivery
  – Delivery to hospitals.
• A detailed description of the production
  process is shown in the following diagram.
When Disaster strikes
• During al Jahra Fire
  accident in 2009, KCBB
  was faced with huge
  blood shortage and
  needed 400 donations
  of blood daily to
  maintain its emergency
  supply.
When Disaster strikes
• More recently, during Eid Al-Adha holiday in
  2011 the number of donors dropped to 40
  donors only.
• There were many casualties across Kuwaiti
  hospitals which have led to an acute shortage
  of blood supplies as a result of road accidents
  and illnesses.
Research Methodology
• Accordingly, disasters
  may affect
  supply, demand, or
  even both.
• A quantitative models
  of how blood
  banks, KCBB in
  specific, should react to
  disasters are very
  limited.
Research Methodology
• This research aims to
  analyze the production
  process and supply chain
  management of KCBB via
  simulation modeling.
• The objective of the
  simulation model is to
  identify:
   – Problems of the current
     KCBB production system.
   – Problems of KCBB’s Supply
     Chain.
Research Methodology
• Moreover, simulation will aid to conduct
  sensitivity analysis that will enable to test the
  current KCBB system against:
  – The surge of unexpected demand during time of
    crises
  – The issue of donation shortages during scarcity
    time, such as holidays.
Performance Measures
• Production cycle time:
  – Enables to distinguish the production time for all
    blood components from the point of donation until
    they are ready for delivery.
• Blood wastage:
  – in order to be minimized, its important to know its
    causes through out the production and supply chain
    system.
• Blood shortage:
  – Simulation will enable to determine how much, how
    often, and of what components blood shortages occur
    in KCBB system.
Thank You

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Dr. Raed Hussein - the production and supply chain management of kuwait

  • 1. The Production and Supply Chain Management of Kuwait Central Blood Bank against Disastrous Times Dr. Raed Al-Husain Department of Quantitative Methods and Information Systems Kuwait University
  • 2. Facts • According to World Health Organization (WHO) (2011), while the need for secure supply of blood continues to grow, more than 70 countries lack the necessary rate of blood donation in order to meet their required demand, and many patients die due to shortages in blood supply.
  • 3. Facts • News Medical (2010) reported that a study conducted on hospitals in the U.S. and Europe, that annual expenditures on blood and transfusion for surgical patients costs $1.6 to $6.0 million per hospital, 37% higher than estimated by prior studies.
  • 4. Facts • Nationwide Blood Collection and Utilization Survey Report (2007) stated that 4.5 million Americans will need blood transfusion each year, yet only 37 percent of the U.S. population is eligible to donate blood and less than 10% do annually.
  • 5. Facts • A study by Cant (2006) stated that in 2001, 7% of U.S. hospitals had to postpone surgeries due to shortages in blood inventories. • A survey study conducted by Toner (2011)in the U.S., states that the cost of acquisition, screening, and transfusion of blood had increased over the past 5 years due to blood shortages.
  • 6. Facts • In order to cope with its increasing cost and instability of supply, effective and efficient supply chain practices of blood is essential to ensure blood transfusion procedures for those in need.
  • 7. Blood Basics • Blood banks fractionate the whole blood in to different components: – Cryoprecipitate (Cryo): • prepared from Plasma and be kept Frozen and has a shelf life of up to one year. – White blood cells (leukocytes): • Transfusion is rare and can last from 18 – 36 hours. – Red blood cells (RBC): • Most common in the blood and has a shelf life of about 35 days.
  • 8. Blood Basics – Platelets: • They cannot be refrigerated or frozen as they will be destroyed, which make them very valuable product and require extra care when dealt • Platelets have a shelf life of 5 days only. – Plasma: • It has shelf life of up to 2 years and can be frozen. – Fresh frozen plasma (FFP): • very similar to plasma's content except that it is prepared and frozen at -18 C○ or colder within 8 hours from donation time, whereas plasma is frozen within 24 hours of donation time.
  • 9. Blood Basics • Blood types are divided into different groups referred to as the ABO groups. • There are 8 different ABO group types
  • 10. Blood Basics • The most common blood types are O+ and A+, but they are also the types that cause the most concern. • Many potential donors with these types of blood are reluctant to donate thinking that their blood is not needed much, where in reality their blood type is really used more than twice as much as any other types.
  • 11. Blood Basics • The rarest type is AB-. • It has been estimated that only about 1 in 170 people have this type. • Next most rare blood type is the B-, About 1 in every 70 people has this type.
  • 13. Blood Supply Chain • Donation Process: – It starts with a volunteer donor who gives a unit of 417ml of blood cells. – The blood donation process could take place either at a local blood bank, or at a different blood donation sites. – The donated blood is then transferred to the nearest processing center, or any alternative center in case of overflow or emergency demand.
  • 14. Blood Supply Chain • Blood Processing: – At the processing center a blood unit is tested and processed into different components. – After the testing is being completed and the blood cell unit is being approved, it is then transferred to a hospital in need, either based on a schedule or an emergency requisition.
  • 15. Blood Supply Chain • Blood Transfusion at Hospitals: – A blood bank within the hospital then makes that blood available to a patient and eventually transfused. – A blood unit that is crossmatched for transfusion and labeled as assigned inventory but not used, is returned to the hospital's unassigned inventory. – An excess in blood inventory at a local hospital could be returned to a processing center where it is reallocated again to different hospitals.
  • 16. Major Issues of Blood SC • Wastage of blood components: – For RBCs, wastage can be caused due to time expiry and out of temperature control due to refrigerator failure. – For platelets, over 95% of wastage is due to time expiry either within the blood processing center or the hospital as well, in which they are ordered for surgical purposes but then fail to be transfused; hence unable to be returned to the blood processing center or allocated for another patient.
  • 17. Major Issues of Blood SC • Transfusion mismatch: – Caused from patients receiving the wrong blood type. – Although it is rare, it remains an important cause of mortality.
  • 18. Major Issues of Blood SC • Blood shortages: – Blood shortages normally occur in areas where disasters strike. – Another reason for the blood shortage include increased use of blood for more advanced procedures than blood transfusion.
  • 19. Major Issues of Blood SC • Collaboration between all various elements of the supply chain: – Caused by the lack of data sharing of supply chain players (donation centers, processing centers, and hospitals). – Lack of horizontal visibility at the end of the supply chain. – Hospitals are usually individually responsible for the fate of the blood.
  • 20. Literature Review • The interest in the management of blood banks services dates back to the early 1960s. • However, only most recent work will be discussed here.
  • 21. Literature Review • Angelis et al. (2001) developed a goal programming model with multi-product and multi-period to determine the best assignment of blood resources to demand. • The objective of their model is to minimize the quantity of blood imported from outside the system and stabilize the quantities assigned daily.
  • 22. Literature Review • Kozan (2001) developed a stochastic model that simulates the blood bank inventory system of a hospital over a finite number of days. • The study examined the influence of mean and variation of daily transfusion, the remaining shelf life of blood units shipped from the blood supplier, and the number of days between consecutive shipments on blood outdates and shortages.
  • 23. Literature Review • Blake et al. (2003) developed a dynamic programming model to determine local inventory ordering policies for platelet suppliers. • Bosnes et al. (2005) used regression analysis in order to predict the daily number of blood donors arrival in peruse to minimize the waiting time in blood donation centers.
  • 24. Literature Review • Katsaliaki and Brailsford (2007) conducted a case study on a UK hospital blood inventory system. • A simulation model was used to monitor the entire supply chain of blood, from donor to recipient. • Their objective was to determine an ordering policy that will lead to the reduction in blood shortages and wastages, increased service levels, improved safety procedures, and reduced costs.
  • 25. Literature Review • A similar study was conducted by Jennings (2009), where a detailed inventory model of a hospital blood bank was developed using simulation. • The main objective was to study the effect of the hospital's inventory policies on blood shortages and blood outdates.
  • 26. Kuwait Central Blood Bank (KCBB) • KCBB is the major blood provider in Kuwait for both governmental and privet hospitals. • The blood supply chain network of KCBB is very similar to the general network shown earlier. • However, the unused blood units at hospitals are kept in their local blood bank inventory and not returned back to KCBB.
  • 27. Kuwait Central Blood Bank (KCBB) • KCBB produces 6 types of blood components: 1. Leukocyte reduced RBCs (LR-RBCs) 2. Leukocyte reduced FFP (LR-FFP) 3. Cryo-depleted plasma (Plasma) 4. Cryoprecipitate (Cryo) 5. Apheresis FFP (APH-FFP) 6. Platelet Apheresis (PC-APH)
  • 28. Kuwait Central Blood Bank (KCBB)
  • 29. Kuwait Central Blood Bank (KCBB) • The production process at KCBB includes the following stages: – Registration and donation – Testing and processing – Storing and delivery – Delivery to hospitals. • A detailed description of the production process is shown in the following diagram.
  • 30.
  • 31. When Disaster strikes • During al Jahra Fire accident in 2009, KCBB was faced with huge blood shortage and needed 400 donations of blood daily to maintain its emergency supply.
  • 32. When Disaster strikes • More recently, during Eid Al-Adha holiday in 2011 the number of donors dropped to 40 donors only. • There were many casualties across Kuwaiti hospitals which have led to an acute shortage of blood supplies as a result of road accidents and illnesses.
  • 33. Research Methodology • Accordingly, disasters may affect supply, demand, or even both. • A quantitative models of how blood banks, KCBB in specific, should react to disasters are very limited.
  • 34. Research Methodology • This research aims to analyze the production process and supply chain management of KCBB via simulation modeling. • The objective of the simulation model is to identify: – Problems of the current KCBB production system. – Problems of KCBB’s Supply Chain.
  • 35. Research Methodology • Moreover, simulation will aid to conduct sensitivity analysis that will enable to test the current KCBB system against: – The surge of unexpected demand during time of crises – The issue of donation shortages during scarcity time, such as holidays.
  • 36. Performance Measures • Production cycle time: – Enables to distinguish the production time for all blood components from the point of donation until they are ready for delivery. • Blood wastage: – in order to be minimized, its important to know its causes through out the production and supply chain system. • Blood shortage: – Simulation will enable to determine how much, how often, and of what components blood shortages occur in KCBB system.