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: 2020
• 资助国家: 加拿大
• 起止时间: 2020-01-01 至 2021-12-31
• 项目状态: 已结题
• 来源: https://www.nserc-crsng.gc.ca/ase-oro/Details-Detailles_eng.asp?id=708310
• 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（CBS）花费10亿美元为加拿大人提供安全的血液供应。随着限制成本的压力越来越大，有必要提高血液供应链的效率。 血液制品易腐烂，因此容易浪费。管理血液库存是困难的，因为订购决策必须考虑库存的年龄。从历史上看，血液供应链管理的文献主要集中在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）储存限制的拟议变化，端到端供应链建模最近已成为地球仪研究人员和血液机构感兴趣的话题。 目前，我们正在研究一个模型框架，以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，代表了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的重大进步。我们建议扩展我们的区域模型框架，以解决血液供应链管理中的四个重要问题。 1)RBC保质期缩短的影响：最近的研究对储存后RBC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大增加产品浪费。因此，需要确定RBC保存期缩短的影响。我们将使用我们的区域建模框架来评估十个CBS血液分配网络中每个网络中RBC的较短保质期。通过评估缩短保存期对一类问题的影响，我们可以概括结果，并就使用新血的成本和效益进行持续的辩论。 2)非先进先出发放政策：已经确立的是，易腐血液制品的最佳政策遵循先进先出（FIFO）规则。然而，RBC保质期缩短的幽灵重新引起了人们对非FIFO政策的兴趣。最近，出现了几篇描述非FIFO发行的论文。这篇文献的一个显着特点是单一的分析范围，只集中在医院的发行政策，更广泛的背景下，如何非FIFO发行政策将在网络中工作尚未进行调查。我们将扩展我们的框架，从网络的角度来评估非FIFO发行政策。 3)年龄公平分配政策：加拿大发给医院的RBC年龄不统一。 较大的设施往往更频繁地周转库存，供应的是较旧的库存，而较小的设施则获得较新的库存。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，有人认为这会导致更频繁的输血需求和一些患者的不良结局。有必要制定发放政策，在整个网络中促进血液制品的公平年龄分配，以确保所有加拿大人都能公平获得安全有效的血液制品。 4)动态库存再平衡：虽然加拿大的库存是在区域一级管理的，但血液是一种国家资源和材料，在区域之间有计划或临时流动。CBS采集的所有RBC中约有20%在研究中心之间转移。没有研究为目前用于重新平衡加拿大血液库存的控制政策建立科学基础。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再平衡策略。 该项目将有助于降低CBS的运营成本，同时在全国范围内促进更可靠地获得所需的血液制品。