Blood supply management ( RBC ): definitions, description as a process, tools for assessment and improvement

Background A patient‐centered vision leads to conceive all transfusion medicine activities as a “blood supply chain”, starting with patients’ needs and ending with transfusion of needed blood components ( BC s) to patients. This blood supply chain comprises two main sectors: the hospitals ‐ where transfusion is ordered by clinicians and administered to patients ‐ and the suppliers, acting from donor management to BC distribution, usually Blood Establishments ( BE s).The aim is to help all involved actors to assess and improve their blood supply management ( BSM ) for the primary benefit of patients. Materials and methods Blood supply management, focusing on red blood cell concentrates ( RBC ), has been investigated by a working group ( TS 003 WG ) of the European Committee (partial agreement) on blood transfusion ( CD ‐P‐ TS ), and also by an ISBT working party on BSM . From scientific literature, current members’ experiences and definitions of basic terms (use, demand, needs, self‐sufficiency, RBC supplier), the TS 003 WG first designed BSM as a real process with the following steps. i) Assess past hospital RBC use for patients; ii) Establish a forecast for overall annual supply ( BE s) and use (hospitals); iii) Establish annual blood collection program ( BE s); iv) Weekly balance RBC use and supply in both BE s and hospitals; v) Review and update the patients’ RBC needs and their satisfaction. This process has been used as a basis to elaborate a questionnaire to investigate each step of the BSM process in the Council of Europe (CoE) countries, and CoE observers (Australia, Canada, New Zealand and USA ) Results The most striking outcomes from the survey were as following. Of 45 surveyed countries, 39 (87%) responded. The blood supply chain ( BSC ) structures could be classified in three main types: National BE based, 100% hospital based and mix of different organisations. Information exchange between hospitals and RBC supplier(s) was frequently lacking. A national effective coordination of BSM could be found in countries with any of the three BSC organisations. A “vein to vein” IT system covering the entire BSC appeared to be of major importance to achieve such national coordination of BSM . The results of the study have been presented and discussed at a symposium organised by the CoE in October 2012. This provided an opportunity to evaluate the use of the TS 003 questionnaire, combined with a SWOT (strengths, weaknesses, opportunities and threats) analysis, to self‐assess the current status of BSM in a given country and to deduce measures for improvement. This experience, deemed very fruitful by all participating countries, can be considered as a first validation of the proposed tool and method Conclusions The self‐assessment TS 003 questionnaire combined with a SWOT analysis may be considered as an effective tool to evaluate current situation of BSM , deduce measures for improvement and assess their effectiveness. A complementary study by the ISBT BSM WP should help to further disseminate, evaluate and improve this tool and method in a larger number of countries, and gain additional knowledge to establish Good practices in BSM , for the primary benefit of patients, and also all other involved stakeholders.