Introduction

The Manager of a local hospital has asked for your help. She thinks that the blood transfusion activity at the hospital is in need of improvement, and has identified a number of problems for which she would like some analysis to be conducted. Unfortunately, there is no one in the Department with the necessary skills to conduct the analysis. You have been asked to focus on three problems, and provide a suitable management report to support the Manager’s decision-making.

Task 1: Exploratory analysis

The hospital manager you have been asked to help faces a difficulty. Although O- blood is universal, in the sense that it can be used safely with virtually all patents, it is also in short supply. Table 1 indicates that only around 7% of the UK population is O- and, by implication, only around 7% of blood donations will be O-.

The manager would prefer medical staff to be using appropriately matched blood wherever possible and restricting the use of O- blood to those patients who really need it: those patients who are actually O- and those patients who require an emergency blood transfusion, On the other hand, the manager does not want donated blood to be wasted, which can happen if blood is not used within its shelf life. As a result, she has carried out some data collection in the hospital over the last six months. A record has been kept of every patient who received O- blood during that period.

Part 2: Decision Analysis

As part of a wider improvement initiative, the hospital manager is considering how the hospital’s blood bank service can be made more efficient and more effective. At present, the main blood bank, where donated blood is stored, is at a large regional hospital about 80km away. The local hospital has only a small blood bank facility where typically only a few days’ supplies of blood can be safely stored. The regional hospital routinely supplies blood on an anticipated or forecast basis and these stocks are replenished every few days or, in the event of a stock shortage at the local hospital, can be shipped through at a few hours’ notice. The hospital manager is reviewing a number of options and has heard about the use of multi-criteria methods. She has asked you to develop an outline multi-criteria model to help her reach a decision between the options.

• Continue the existing system. In one sense this would be the easiest option. However, it also carries some risks as the hospital occasionally experiences times when it runs out of stocks of certain blood types and emergency supplies have to be sent across from the regional hospital. The cost of this is high contributing to budget overspending and there are also clinical risks for patients. There have also been occasions in some winters where emergency supplies have not been able to be sent because of severe weather conditions.
• Expand the blood bank at the local hospital to allow it to carry its own stock requirements in full.  The local blood bank would then be effectively independent which would contribute to minimizing risk to patients of blood supply shortage. However, the capital cost of this would be high and in the current economic climate might be difficult to obtain. Once built the hospital would also incur higher annual running costs.
• Improve the local hospital’s  Management  Information  System and stock control system. At present, the local hospital does little to try to predict blood use requirements or to manage its blood stocks effectively. This option would focus on two things. First, better analysis and forecasting of blood use requirements in the hospital is linked to the scheduling of patient treatments and surgical operations. It is felt that this would enable the hospital to better and more accurately predict the blood it requires.
  Secondly, investing in an up-to-date stock control system so that blood supplies are more effectively tracked and monitored to reduce wastage, stock levels, and associated costs. Most of the effort under this option would go into the development of better IT/IS systems. Anticipated development costs are around £100,000 with ongoing costs on an annual basis of around £50,000.