Using operational research methods to improve decision making in Canada's blood supply chain

利用运筹学方法改善加拿大血液供应链的决策

• 批准号: RGPIN-2014-06278
• 负责人: Blake, John
• 金额: $ 1.46万
• 依托单位: Dalhousie University
• 依托单位国家: 加拿大
• 项目类别: Discovery Grants Program - Individual
• 财政年份: 2014
• 资助国家: 加拿大
• 起止时间: 2014-01-01 至 2015-12-31
• 项目状态: 已结题
• 来源: https://www.nserc-crsng.gc.ca/ase-oro/Details-Detailles_eng.asp?id=567710
• 关键词: Using; operational; research; methods; improve

Canadian Blood Services (CBS) spends $1B to provide Canadians with a safe supply of blood. As pressures mount to constrain costs, there is a need to improve the efficiency of the blood supply chain. Blood products are perishable and thus subject to wastage. Managing blood inventory is difficult because ordering decisions must consider the age of stock. Historically, the literature on blood supply chain management has focused on Red Blood Cell (RBC) inventory policies for a single supplier or consumer. However, because of proposed changes to the storage limits of red blood cells (RBC), end-to-end supply chain modelling has recently become a topic of interest for researchers and blood agencies around the globe. Currently, we are working on a modelling framework to represent ten regional blood distribution networks in Canada. Our ongoing work has produced an approach that represents a significant step forward in terms of scope, detail, and re-usability of supply chain models for regional blood distribution networks. We propose to extend our regional modelling framework to address four important issues in blood supply chain management. 1) The impact of a shorter shelf-life for RBC: Recent studies have raised questions about the safety of RBC after storage. However, reducing shelf life would likely create shortages or substantially increase product wastage. Thus, there is a need to determine the impact of a reduced shelf life for RBC. We will use our regional modelling framework to evaluate a shorter shelf life for RBC in each of the ten CBS blood distribution networks. By evaluating the impact of a shorter shelf life across a class of problems we can generalize results and frame the ongoing debate regarding the costs and benefits of transfusing newer blood. 2) Non-FIFO issuing policies: It has been well established that optimal policies for perishable blood products follow first-in-first-out (FIFO) rules. However, the spectre of a shorter shelf life for RBC has renewed interest in non-FIFO policies. Recently, several papers describing non-FIFO issuing have appeared. A distinguishing feature of this literature is the unitary scope of analysis, which focuses only on hospital issuing policies; the broader context of how non-FIFO issuing policies would work in a network has not yet been investigated. We will extend our framework to evaluate non-FIFO issuing policies from a network standpoint. 3) Age equitable distribution policies: The age of RBC issued to hospitals in Canada is not uniform. Larger facilities, which tend to turn stock more frequently, are supplied with older stock, while smaller facilities get newer stock. This practice maximizes product availability at distant sites and lowers delivery costs. However, it has been suggested that it leads to more frequent transfusion requirements and poorer outcomes for some patients. There is a need to develop issuing policies that promote equitable age distribution of blood products across an entire network to ensure all Canadians have equitable access to safe and effective blood products. 4) Dynamic inventory re-balancing: While inventory is managed on a regional level in Canada, blood is a national resource and materials flow, either on a planned or ad hoc basis, between regions. Approximately 20% of all RBC collected by CBS are transferred between sites. No study has established a scientific basis for control policies currently used to re-balance blood inventory in Canada. We will employ simulation based optimization (SBO) methods to evaluate policies for inventory re-balancing between CBS distribution sites. This project will help to reduce operational costs at CBS while promoting more reliable access to needed blood products across the country.

加拿大血液服务中心 (CBS) 花费 10 亿美元为加拿大人提供安全的血液供应。随着成本压力的增加，需要提高血液供应链的效率。血液制品容易腐烂，因此容易被浪费。管理血液库存很困难，因为订购决策必须考虑库存的年龄。从历史上看，有关血液供应链管理的文献主要集中于单个供应商或消费者的红细胞 (RBC) 库存政策。然而，由于红细胞 (RBC) 存储限制的拟议变更，端到端供应链建模最近已成为全球研究人员和血液机构感兴趣的话题。目前，我们正在开发一个建模框架来代表加拿大的十个区域血液分配网络。我们正在进行的工作已经产生了一种方法，该方法在区域血液分配网络供应链模型的范围、细节和可重用性方面向前迈出了重要一步。我们建议扩展我们的区域建模框架，以解决血液供应链管理中的四个重要问题。 1) 红细胞保质期较短的影响：最近的研究对红细胞储存后的安全性提出了质疑。然而，缩短保质期可能会造成短缺或大幅增加产品浪费。因此，需要确定红细胞保质期缩短的影响。我们将使用我们的区域建模框架来评估 10 个 CBS 血液分配网络中每个红细胞的较短保质期。通过评估较短保质期对一系列问题的影响，我们可以概括结果并框架关于输注新血液的成本和收益的持续争论。 2) 非 FIFO 发放政策：众所周知，易腐烂血液制品的最佳政策遵循先进先出 (FIFO) 规则。然而，RBC 保质期较短的担忧重新燃起了人们对非先进先出政策的兴趣。最近，出现了几篇描述非 FIFO 发行的论文。该文献的一个显着特点是分析范围单一，仅关注医院发布的政策；非 FIFO 发布策略如何在网络中发挥作用的更广泛背景尚未得到研究。我们将扩展我们的框架，从网络的角度评估非 FIFO 发行策略。 3）年龄公平分配政策：加拿大各医院发放的RBC年龄并不统一。较大的设施往往更频繁地周转库存，供应较旧的库存，而较小的设施则供应较新的库存。这种做法最大限度地提高了远程站点的产品可用性并降低了交付成本。然而，有人认为这会导致一些患者更频繁的输血需求和更差的结果。有必要制定发行政策，促进整个网络中血液制品的公平年龄分配，以确保所有加拿大人都能公平地获得安全有效的血液制品。 4) 动态库存重新平衡：虽然加拿大的库存是在区域层面上管理的，但血液是国家资源和材料的流动，无论是有计划的还是临时的，在区域之间流动。 CBS 收集的所有红细胞中约有 20% 在站点之间转移。目前还没有研究为加拿大目前用于重新平衡血液库存的控制政策建立科学依据。我们将采用基于模拟的优化 (SBO) 方法来评估 CBS 分销站点之间的库存重新平衡策略。该项目将有助于降低 CBS 的运营成本，同时促进全国范围内更可靠地获取所需的血液制品。