Improving Canada's blood network using operational research

简介：加拿大人每年在血液的采集、生产、检测和分配上花费超过10亿美元。加拿大血液服务局（CBS）最初成立的目的是管理加拿大的血液供应链，现在的任务包括可输血的血液产品，协调加拿大的分离蛋白产品供应，管理国家干细胞登记和脐带血库，以及监督加拿大各地的器官和组织捐赠。自2011年以来，我在达尔豪斯大学和哥伦比亚广播公司共同担任研究工程师。在这段时间里，我的实验室建立了一个项目组合，影响了向加拿大人提供医疗保健，并在将运筹学模型应用于血液供应链问题方面积累了重要的专业知识。目标：该研究项目的长期目标是推进运筹学工具在血液供应链新领域的应用，建立解决复杂现实世界血液供应链问题的新方法，并创造工具，帮助科学家和政策制定者在该领域进行高质量的研究。我们提出三条调查路线，以实现以下短期目标。1)将优化方法整合到我们现有的供应链建模框架中，以促进改进决策，特别是与将低滴度O型全血（LTOWB）引入加拿大处方有关的决策，并创建为医院制定在线订购指南的程序。2)创建可重用的、可扩展的、开源的模拟软件对象，用于血液采集和生产过程的基本建模，并使这些工具可供研究界使用。这些物体将在模拟采血诊所的献血者流动和处理病原体减少的血小板的项目中进行测试。软件对象将作为库发布给使用Git和PyPI等开源软件开发平台的外部研究人员。3)基于加拿大的数据，开发一个模拟框架，用于评估与加拿大成人干细胞登记相关的政策决策，并将供体/受体匹配整合到干细胞供体招募策略的评估中。我们将建立一个在线匹配门户网站，用加拿大的数据填充它，并测试它在加拿大成人干细胞注册中的应用，以确定是为国际市场招募罕见的加拿大供体更好，还是集中招募最有可能与加拿大患者匹配的人群更好。影响：本提案概述了一项计划，在与哥伦比亚广播公司现有合作的基础上建立一个研究方案，以补充文献，为高素质人员提供培训平台，并促进所有加拿大人的健康。

Introduction: Canadians spend more than $1B annually on the collection, production, testing, and distribution of blood. Originally founded to manage Canada's blood supply chain, Canadian Blood Services' (CBS) mandate now includes transfusable blood products, coordinating Canada's fractionated protein product supply, managing the national stem cell registry and cord blood bank, and overseeing organ and tissue donation throughout Canada. Since 2011, I have held a joint appointment at Dalhousie University and CBS as a research engineer. Over this time, my lab has built a portfolio of projects that has impacted the provision of health care to Canadians and has accumulated significant expertise in the application of operational research models to blood supply chain issues.   Objectives: The long-term objectives of this research program are to advance the application of operations research tools into novel areas of the blood supply chain, to build new methods for solving complex real-world blood supply chain issues and to create tools that will assist scientists and policy makers undertake high-quality research in this field. We propose three lines of investigation with the following short-term objectives. 1)To integrate optimization methods into our existing supply chain modelling framework to foster improved decision making, specifically related to the introduction of low titre O whole blood (LTOWB) into the Canadian formulary and to create a procedure for setting online ordering guidelines for hospitals. 2)To create re-usable, extensible, open-source simulation software objects for elemental modelling of blood collection and production processes and to make such tools available to the research community. These objects will be tested on projects for simulating donor flow in blood collection clinics and for processing pathogen reduced platelets. Software objects will be released as libraries to external researchers using open-source software development platforms such at Git and PyPI. 3)To develop a simulation framework for evaluating policy decisions related to Canada's adult stem cell registry, based on Canadian data, and integrating donor/recipient matching into evaluation of stem cell donor recruitment strategies. We will build an online matching portal, populate it with Canadian data, and test its application to the Canadian Adult Stem Cell registry to determine whether it is better to recruit rare Canadian donors for the international market or concentrate on recruiting populations that are most likely to match to Canadian patients. Impact: This proposal outlines a plan to build on an existing collaboration with CBS to create a research program that adds to the literature, provides a training platform for highly qualified personnel, and contributes to the health of all Canadians.