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

Abstract

BackgroundTraditional key performance indicators (KPIs) for red blood cell (RBC) inventory management such as blood shortage rate (BSR) and outdate rate (ODR) alone are observed to be insensitive for large hospitals, often due to fluctuating demands and rapid turnover. We hypothesized that improvement in complementary KPIs for RBC supply chains, including age of blood as a surrogate for the pre‐hospital and in‐hospital supply chains, may further improve efficiency.MethodsRed blood cell supply, inventory and disposition data from a large tertiary care hospital blood bank were retrospectively assessed from June 2014 to 2015 as the baseline period. From June 2015 to 2016, (1) collaboration with the blood supplier to improve logistics and (2) a ‘demand‐driven inventory planning policy’ (DDIP) to determine better inventory levels aided by discrete‐event simulation modelling were instituted. Age of blood transfused (ABT) was chosen as the main KPI for the efficiency of the entire RBC supply chain.ResultsImprovements in age of blood received (ABR) led to the greatest efficiency gains. Reduction in ABT (28.7 ± 8.8 days vs. 22.1 ± 9.5 days, P < 0.01), ABR (19.4 ± 8.8 days vs. 13.4 ± 7.0 days, P < 0.01), inventory‐to‐transfusion ratio (P < 0.01), O‐negative RBC utilization (7.4 vs. 6.4 units/day, P < 0.01) and ODR (P < 0.01) compared to the baseline period was observed without a significant increase in BSR.ConclusionCollaboration with the blood supplier to improve logistics, implementation of DDIP to determine better inventory levels and use of KPIs other than BSR and ODR led to inventory efficiency gains in a large tertiary care hospital blood bank.