STRATEGY DYNAMICS

SESSION 5

MODEL BLOOD BANK, INDORE

PGP 2021-23
5th February 2023
 THE STORY
The blood bank is situated in the heart of the city and supplies to recipients blood units
tested, separated into components, and typed. It is a free-standing facility and not part of
a hospital or laboratory, and therefore the demand for its products are fully external in
nature.

The recipients are mostly accident victims, patients undergoing surgery, and patients
being treated for cancer, thalassemia and other diseases which need infusion of blood.

The supply of blood came mostly from voluntary unpaid donors in blood donation camps
and such camps were organized at different parts of the city throughout the year. There
were also professional paid donors who charged a fee for blood donation, but such donors
accounted for less than 5% of the total supply.

According to World Health Organization (WHO) recommendations all blood donations

should be screened for infections prior to use and screening for HIV, hepatitis B, hepatitis
C, and syphilis should be mandatory. WHO also recommended that blood collection should
be only from non-remunerated voluntary donors as paid donors were found to have a
greater prevalence of blood-borne diseases and infections.
 CHALLENGES

There are a large number of blood products. Blood may be stored as whole blood, or
may be separated into different components through fractionation – red blood cells,
platelets, and plasma. There are 8 major blood types – O+, O-, A+, A-, B+, B-, AB+, and
AB-. Therefore the blood bank would be required to handle at least 32 different product
categories.

Blood is a perishable commodity with the whole blood and the fractionated components
each having a different useful life – whole blood and red blood cells (35-42 days); platelets
(4-5 days); and plasma (1-1.5 year). Keeping a large inventory may lead to wastage and
keeping a small inventory may cause shortages. Therefore, the blood bank requires a
method to accurately forecast the monthly demand for blood units and the supply chain to
meet the requirements related to product perishability.
Both supply and demand are stochastic in nature.

The number of donors coming to a blood donation camp is often random in nature and
not easy to predict. The blood type of donor may be ascertained only after testing which
further complicates the supply chain issues. Increasing the frequency of blood donation
camps and or the quantities of blood collected per camp increases the overall collection
of blood units. However, this leads to increase in storage costs and could also result in
wastage.

On the demand side forecasting demand for blood units is difficult as it also follows a
random behavior with large variations in order received by the blood bank. The city faces
acute shortage of blood units throughout the year and the blood bank tries its best to meet
the demand. The blood bank faces the problem of demand fluctuations during a year and
predicting such demand is a difficult task, as is the number of donors who would arrive at
the blood donation camps.

Our challenge is to design a supply chain which will minimize costs related to excess
inventory and wastage, and revenue loss from shortage.
 THE SUPPLY CHAIN

Blood is collected in specially designed plastic bags that have an anticoagulant solution. Single bags
are used to collect whole blood, while triple bags are used to store components recovered after
fractionation of whole blood.

The collected blood units are brought to the blood bank laboratory and tested in the laboratory to
ensure that they are safe for use. The triple bags are centrifuged at high speed. Due to the
difference in their densities the three components separate out in the triple bag system – plasma in
the top layer, platelets in the middle, and red blood cells in the bottom. The components are then
drained out into three bags, sealed and sent to storage. As per WHO recommendations the process
of testing, componentization, typing, and storage needs to be completed within six hours of
collection to ensure viability of the components.

Whole blood and red blood cells are stored at 2-6 degrees Celsius (OC) for a maximum duration of 35
days. Platelets are stored at room temperature (21-22 OC) for a maximum duration of 5 days. Plasma
is stored in a frozen state at -25OC for up to one year, and at -18 OC for up to one and a half years.
Red blood cells carry oxygen and are used to treat anemia. Platelets control bleeding and are used to
treat leukemia and other forms of cancer. Plasma is used to control bleeding due to low levels of
clotting factors, and to treat burn and trauma victims.
 THE MODEL
We set the model for a 12 month time period.

We start the model design with the supply side activities involving blood donation
camps where whole blood is collected from donors. The rate valve, supply of blood
units is the number of blood units collected per month which again is the number of
camps held per month and the average number of collection of blood units per camp
for that month. 2% of the blood collected is rejected mainly due to wastage.
 EQUATIONS
no. of camps = WITH LOOKUP (Time, ([(0,0)
(12,30)],(0,21),(1,12),(2,15),(3,12),(4,8),(5,15),(6,10),(7,14),(8,13),(9,13),(10,19),(
11,13))) Units: Dmnl
collection per camp = WITH LOOKUP (Time,([(0,100)-
(13,350)],(0,173),(1,200),(2,224),(3,301),(4,209),(5,274),(6,288),(7,202),(8,23
0),(9,197),(10,197),(11,184) )) Units: blood units
supply of blood units="no. of camps"*collection per camp*(1-rejection rate)
Units: blood units per month

rejection rate=0.02 Units: Dmnl

Whole Blood= INTEG (supply of blood units-units for componentization,0)

Units: blood units
RUN A SIMULATION
 THE FULL MODEL
Plasma Stock
plasma issue

plasma waste rate

rejection rate
plasma wastage
fraction
<Time>
Whole Blood RBC Stock
units for rbc issue
supply of blood units componentization
rbc wastage rate

collection per no. of camps rbc wastage

camp fraction
Platelet Stock
<Time> platelet issue
Drawing Bent Pipes: Start the rate as usual (select the Rate tool and platelet wastage
click once on a blank part of the sketch or on a level), then move the fraction
platelet wastage rate
cursor to a place you want the pipe bent, hold down the shift key and
click once on the sketch. This drops a “corner”. If you want more
bends/corners, keep holding down the shift key and click on the
sketch. Finish the rate by clicking without holding the shift key down.
 EQUATIONS

As per WHO guidelines, testing and componentization is to be completed within 6

hours of collection.

The DELAY FIXED function is used since the supply of whole blood from
collection point to componentization is a FIFO (first in first out) activity. 6 hours
is approximately equivalent to 0.008 hours.

DELAY FIXED is denoted by the nomenclature DELAY FIXED (input, delay

time, initial value) and the function returns the value of the input delayed by
the delay time.

Therefore, the equation for the variable units for componentization is as follows:

units for componentization=DELAY FIXED(supply of blood units, 0.008 , 0 )

Units: blood units
RBC

RBC issue over a 12 month period is assumed to be as shown in the LOOKUP

FUNCTION
rbc wastage rate=units for componentization*rbc wastage fraction

Units: blood units per month

rbc wastage fraction=0.02

Units: Dmnl

RBC Stock= INTEG (units for componentization-rbc issue-rbc wastage rate,0)

Units: blood units

 Plasma

plasma issue=rbc issue*0.5 Units: blood units per month

plasma waste rate=units for componentization*plasma wastage fraction

Units: blood units per month

plasma wastage fraction=0.02 Units: Dmnl

Plasma Stock= INTEG (units for componentization-plasma issue-plasma waste rate,0)

Units: blood units
 Platelet

platelet issue=rbc issue*0.4 Units: blood units per month

platelet wastage rate=units for componentization*platelet wastage fraction

Units: blood units per month

platelet wastage fraction=0.02

Units: Dmnl

Platelet Stock= INTEG (units for componentization-platelet issue-platelet wastage rate, 0)

Units: blood units
 OUTPUT
Select the variables:
units for componentization,
plasma issue, Plasma Stock, Click on Table icon
platelet issue, Platelet Stock,
rbc issue, RBC Stock.
Select the variables: supply of blood units, Whole Blood, units for componentization.

Click on Graph icon.

Select the variables: Plasma Stock, RBC Stock, Platelet Stock.

Click on Graph icon.

 SYNTHESIM
Click on SYNTHESIM button

Plasma Stock
plasma issue

plasma waste rate

rejection rate
plasma wastage
fraction
<Time>
Whole Blood RBC Stock
units for rbc issue
supply of blood units componentization
rbc wastage rate

collection per no. of camps rbc wastage

camp fraction
Platelet Stock
<Time> platelet issue
platelet wastage
fraction
platelet wastage rate

Adjust the blue colored variables to adjust stocks.

THANK YOU