Article2022

A data‐informed system to manage scarce blood product allocation in a randomized controlled trial of convalescent plasma

Na Li · Michelle P. Zeller · Andrew W.Y. Shih · Nancy M. Heddle · Melanie St John · Philippe Bégin +7 more

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Blood donation and transfusion practices Supply Chain and Inventory Management Facility Location and Emergency Management

Abstract

BACKGROUND: Equitable allocation of scarce blood products needed for a randomized controlled trial (RCT) is a complex decision-making process within the blood supply chain. Strategies to improve resource allocation in this setting are lacking. METHODS: We designed a custom-made, computerized system to manage the inventory and allocation of COVID-19 convalescent plasma (CCP) in a multi-site RCT, CONCOR-1. A hub-and-spoke distribution model enabled real-time inventory monitoring and assignment for randomization. A live CCP inventory system using REDCap was programmed for spoke sites to reserve, assign, and order CCP from hospital hubs. A data-driven mixed-integer programming model with supply and demand forecasting was developed to guide the equitable allocation of CCP at hubs across Canada (excluding Québec). RESULTS: 18/38 hospital study sites were hubs with a median of 2 spoke sites per hub. A total of 394.5 500-ml doses of CCP were distributed; 349.5 (88.6%) doses were transfused; 9.5 (2.4%) were wasted due to mechanical damage sustained to the blood bags; 35.5 (9.0%) were unused at the end of the trial. Due to supply shortages, 53/394.5 (13.4%) doses were imported from Héma-Québec to Canadian Blood Services (CBS), and 125 (31.7%) were transferred between CBS regional distribution centers to meet demand. 137/349.5 (39.2%) and 212.5 (60.8%) doses were transfused at hubs and spoke sites, respectively. The mean percentages of total unmet demand were similar across the hubs, indicating equitable allocation, using our model. CONCLUSION: Computerized tools can provide efficient and immediate solutions for equitable allocation decisions of scarce blood products in RCTs.

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2013Challenges in the management of the blood supply 2016Blood supply chain network design considering blood group compatibility under uncertainty 2019Survey on blood supply chain management: Models and methods 2012Blood Inventory Management: Hospital Best Practice 2021Fairness of the Distribution of Public Medical and Health Resources 2022Towards an Optimized and Sustainable Blood Supply Chain Network under Uncertainty: A Literature Review 2021A decision integration strategy for short-term demand forecasting and ordering for red blood cell components 1999Network design in supply chain management

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