Abstract
The Operations Research (OR) and Operations Management (OM) community has witnessed significant progress in the field of research in blood bank inventory management during the past few decades. The OR and OM community has studied blood inventory management problems at the level of both individual hospital blood banks (HBB) as well as regional blood banks (RBB). The OR and OM literature at the individual HBB level has mainly focused on the determination of optimal policies for collection, ordering, componentizing, cross-matching and issuing of blood and its products. The literature at the RBB level emphasizes on the optimal policies for transshipment, rotation, distribution and scheduling of blood deliveries from the RBB to the HBBs. The objective of this chapter is twofold. In the first place, it provides the readers with a basic understanding of inventory management related problems commonly faced by HBBs. In the second place, it shows how various OR techniques can be used to manage the inventory of blood products in an efficient manner with the help of a real-life case study. This chapter is organized into seven sections. The first section talks of blood and its components. The second section provides a description of the different types of blood groups. Functioning of a typical blood bank is explained in the third section. The fourth section describes various operational decision-making problems at HBBs. The fifth section details out a real-life case study. The penultimate section describes recommendations for real-life implementations based on the insights obtained from the real-life case study. The chapter concludes with a set of exercises from the area of blood bank inventory management.
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Notes
- 1.
Readers are suggested to refer to Prastacos [27] for an in-depth review of literature on blood bank inventory management
- 2.
This concept of substitution between different blood group types is mostly limited to textbooks in medicine. The transfusions between certain blood group types, as shown in Fig. 18.1, are never actually prescribed unless there is an absolute emergency.
- 3.
One unit is equivalent to one blood bag.
- 4.
Terms like wastage, outdate and discards have been used interchangeably throughout the text. They all refer to expiry of blood items once their useful life (shelf life) is over.
- 5.
Some surgeries require fresh blood and in such cases the oldest unit cannot be transfused to the patient. In some cases the patient blood may not be compatible with the oldest unit in the inventory.
- 6.
For example, whole blood of the same blood group can be given after compatibility testing, when the required component is not available. Also, after fractionation, platelets of any blood group type can be given in case of emergency when the platelets of the required blood group are not available. This is because most of the antibodies, which are responsible for transfusion reactions, remain in the plasma after the fractionation.
- 7.
The data organization at the blood bank under study was quite poor due to absence of computerization. The data entry into various registers was performed manually at the blood bank. The data presented in the chapter, therefore, is presented as was made available to us by the blood bank officials in the Excel sheet “Blood_Bank_Case_Study_DATA.xls”
- 8.
All probability distributions are based on the past data at the blood bank. The data and the distributions will be different for different blood banks.
- 9.
The number of donation camps a blood bank can organize depends on the level of resources at the blood bank and the permission from the various camping sites. It is usually difficult to change the camping frequency in the short run.
- 10.
Refer to Fig. 18.4 for the distribution of T (interval between two successive camps).
- 11.
In cases where a unit of RBC is not available, WB of the same blood group can be usually given after minor processing which removes the platelet and plasma from WB. In the cases where WB is not available, RBC can be given (along with certain fluids if required) to the patient.
- 12.
Fill rate is defined as the percentage of demand satisfied. A fill rate of 80 % means that only 80 % of the demanded items were issued from the inventory. Alternatively, it means that 20 % of the demand was not fulfilled.
- 13.
Except for a few cases, the donated blood units of a given blood type are usually compatible with the patient blood of the same blood type (based on the experience of the blood bank chosen for the study).
- 14.
The cost of collecting blood includes the cost of empty blood bag along with the costs of donor form, Hb testing, donor diet, certificate and testing. As per Table 18.7, the total cost of collecting blood (variable) in an empty single blood bag is ₹ 259.5 while that for an empty triple bag is ₹ 486.5. For simplicity we have assumed these costs to be ₹ 270 and ₹ 500, respectively.
- 15.
- 16.
Since the blood bank needs to ensure the demand from patients is met more often than not, it is assumed arbitrarily for the purpose of illustration that the blood bank would want to satisfy at least 95 % of demand for WB + RBC, 95 % for plasma and 80 % for platelets. The fill rate requirements may be different for different blood banks.
- 17.
For the purpose of cost curves shown in Fig. 18.12 the cost of shortage per unit was assumed to be ₹ 1000 for WB/RBC, ₹ 100 for plasma and ₹ 1000 for platelets. The cost of wastage per unit was assumed to be ₹ 1000 for WB/RBC, ₹ 100 for plasma and ₹ 1000 for platelets.
- 18.
One lakh is equivalent to one hundred thousand (100,000).
- 19.
It is worth mentioning here that the modified (R, T) policy is not the optimum policy for blood collection for the blood bank. It only performs the best among the three collection policies discussed in the chapter. The blood bank may actually come up with a superior policy for blood collection and test its performance using the simulation model described in this chapter.
- 20.
See Q.1 in the exercises given at the end of the chapter.
- 21.
One unit is equivalent to one blood bag.
- 22.
Hint: Use linear programming.
- 23.
In Q.1 it was assumed that the blood bank can arrange any number of donors of a given blood group type for donation at the start of the day. For the purpose of this problem it is assumed that the blood bank can arrange any number of donors to donate blood but their blood group can only be determined after the blood has been physically collected.
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Lowalekar, H., Ravichandran, N. (2015). Inventory Management in Blood Banks. In: Murty, K. (eds) Case Studies in Operations Research. International Series in Operations Research & Management Science, vol 212. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-1007-6_18
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