Assisting hospitals with optimal inventory management

Disclaimer: reposted with permission from Canadian Blood Services
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The Amber Phase declared in December 2022 highlighted the need to have both complete hospital disposition and inventory data. How can the Average Daily Red Cell Demand (ADRD) and Inventory Index (II) assist hospitals with optimal inventory management during green phase (normal) operating conditions?

“In my early years as a charge technologist of transfusion medicine, Canadian Blood Services reminded me to look at blood utilization for their demand forecasting,” says Heather McMahon, Charge Technologist, Blood Transfusion, Laboratory Services, Royal Victoria Regional Health Center in Barrie, Ontario. When the Ontario Regional Blood Coordinating Network’s (ORBCoN) inventory calculator tool was introduced, I used this to determine the target inventory red blood cell levels (green phase) and those required in amber or red phase of our Emergency Blood Management Plan on a yearly basis using my most recent 12-month disposition. It is easy to use and accurate. The current version provides estimated target levels for one, two, five, eight and 10-day inventory stock levels.

Prior to our Canadian Blood Services/Ontario Regional Blood Coordinating Network (ORBCoN) site visit in November 2022, I reviewed the disposition data they provided and noted a decrease in red blood cell utilization in 2021 from the previous two years. The inventory calculator tool was used, and our inventory levels were adjusted. There was a notable reduction from a total of 111 to 101 red blood cells for our routine stock. In determining levels, I also take into account the distance we are from our Canadian Blood Services distribution site (86 km), especially for our stock of group O negative red blood cells, the number of units outdated, the number of routine deliveries per week and noting that we are the regional hospital in our area that may supply blood to other sites in emergencies considering how long a STAT delivery may take.

The National Emergency Blood Management Committee (NEBMC) uses disposition data and daily inventory levels that hospitals submit to Canadian Blood Services to understand the current state of both hospital and Canadian Blood Service inventory during a declared inventory shortage phase, like the recent Amber Phase. To calculate ADRD (red blood cells transfused + wasted ÷ 365 days) for a given hospital, Canadian Blood Services requires 12 current and consecutive months of red blood cell disposition data. To calculate the Inventory Index (current inventory ÷ ADRD) Canadian Blood Services needs a current inventory level submission and the ADRD. If a hospital is not up to date with either disposition or inventory submission, these markers cannot be calculated and then reviewed to understand whether a current inventory phase will continue or move to another phase (into Red or into Recovery). Lack of disposition and inventory data from some hospital customers in several provinces was identified as a gap for the NEBMC. Keeping disposition submissions current, and reporting inventory on a regular basis, and as directed by the Amber Phase Advisory, allows a hospital to practice timely inventory review and update based on a hospital’s own data, as illustrated in the example above.