scholarly journals A Proposed Managerial Model for Improvement of Blood Consumption in the Operating Rooms in Southern Iran

Health Scope ◽  
2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Maryam Gholami ◽  
Kamran Hajinabi ◽  
Leila Riahi ◽  
Sezaneh Haghpanah
Keyword(s):  
Resource Allocation ◽  
Inventory Management ◽  
Financial Burden ◽  
Operating Rooms ◽  
Influential Factors ◽  
Tertiary Referral Hospital ◽  
Utilization Management ◽  
Transportation Equipment ◽  
Southern Iran ◽  
Blood Utilization

Background: The financial burden of blood wastage in operating rooms of hospitals indicates the importance of managing blood consumption. Objectives: To determine the most influential factors affecting blood utilization management in operating rooms. Methods: This cross-sectional study was conducted in the operating rooms of the largest tertiary referral hospital in Southern Iran from September to November 2019. A researcher-made questionnaire was designed, validated, and completed by 185 related stakeholders. Confirmatory factor analysis was conducted. Results: Model fit indices had acceptable values (P = 0.032). In the suggested model, resource allocation (coefficient = 0.81) and control (coefficient = 0.77) were determined as the two most impressive managerial dimensions of blood utilization management. In the resource allocation dimension, the most effective factors were found to be using trained and oriented personnel to inventory management principles and blood bag handling, storage, and transportation rules and providing in-hospital safe and standard blood transportation equipment. In the control dimension, the most influencing subject was evaluating and reporting the reasons for the date expiry of blood products. Conclusions: Implementing a stepwise evidence-based blood consumption program based on the most prioritized suggested initiatives can be highly cost-effective and presented as a practical guide for policymakers, especially in low socio-economic countries. Based on our results, focusing on using trained blood bank staff in all related parts and providing standard blood transportation equipment as well as attempting to minimize the number of discarded blood units in operating rooms can be highly effective in the reduction of blood wastage and improvement of blood consumption status.

scholarly journals Blood Transfusion Practice in Operating Rooms in Nemazee Hospital in Southern Iran

2021 ◽  
Vol 24 (2) ◽  
pp. 107-112
Author(s):  
Sezaneh Haghpanah ◽  
Shima Miladi ◽  
Leila Kasraian ◽  
Ali Zamani ◽  
Maryam Gholami
Keyword(s):  
Blood Transfusion ◽  
Surgical Procedures ◽  
Laboratory Data ◽  
Operating Rooms ◽  
Cross Sectional Study ◽  
Transfusion Practice ◽  
Cross Sectional ◽  
Southern Iran ◽  
Blood Utilization ◽  
Transfusion Ratio

Background: The requests for blood products in elective surgeries exceed actual use, leading to financial wastage and loss of shelf-life. In this study, we assessed the blood transfusion indices in elective surgeries performed in the operating rooms. Methods: In this cross-sectional study, from January to June 2017, a total of 970 adult patients who underwent elective surgeries in the operating rooms of Nemazee hospital, a general referral hospital in southern Iran, were investigated. Demographic, clinical, and laboratory data, such as hemoglobin (Hb), hematocrit (Hct), platelets, prothrombin time (PT), and partial thromboplastin time (PTT) were gathered from medical records. Blood utilization was evaluated using the following indices: cross-match to transfusion ratio (C/T ratio), transfusion probability (T%), transfusion index (TI), and Maximum Surgical Blood Order Schedule (MSBOS). Results: The overall C/T, T%, and TI ratios were 2.49, 46.6%, and 0.83 for all procedures, and the highest and lowest ratios pertained to the thoracic and cardiac surgeries, respectively. The C/T ratio was ≥2.5 for all surgical procedures except for cardiac surgeries. T% was <30 for thoracic and orthopedics surgeries and ≥30 for other surgical procedures. In all surgical procedures, TI was less than 0.5, except for cardiac surgeries. Also, the MSBOS was about 3 units for cardiac surgeries and ranged from 0.5 to 1 units in other surgeries. Conclusion: The results of this study showed a high quality blood transfusion practice in cardiac surgeries, possibly due to more focus on this critical ward. Assessing difficulties in the process of reservation, utilization, and preparation of standard protocols and policies are required to improve the blood utilization practice in operating rooms.

Analysis of Inventory Management in Reverse Supply Chain Using Stochastic Dynamic Programming Model

2008 ◽  
Author(s):  
Badr O. Johar ◽  
Surendra M. Gupta
Keyword(s):  
Dynamic Programming ◽  
Inventory Management ◽  
Reverse Logistics ◽  
Stochastic Dynamic Programming ◽  
Public Awareness ◽  
Financial Burden ◽  
Probabilistic Approach ◽  
Complex Nature ◽  
Stochastic Dynamic

Reverse logistics is a critical topic that has captured the attention of government, private entities and researchers in recent years. This increase in the concern was driven by current set of government regulations, increase of public awareness, and the attractive economic opportunities. Also, environmentalists have always demanded Original Equipment Manufacturers (OEMs) to be more involved and be responsible of their products at the end of its life cycle. However, the uncertainty in quality of items returned, and its quantity discourage OEMs from participating in such programs. Because of the unique problems associated and the complex nature of the reverse logistics activities, numerous studies have been carried out in this field. One of those crucial areas is inventory management of End-of-Life (EOL) products. The take back program could possibly bring financial burden to OEM if it is not managed well. Thus, an efficient yet cost effective system should be implemented to appropriately manage the overwhelming number of returns. Previously, we have analyzed the problem based on the assumption that the number of core products returned and disassembled parts and subassemblies are known in advance. In this paper, we introduce a probabilistic approach where different quality levels of for every component disassembled are considered and different probabilities of these qualities given the quality of the returned product. The model utilizes a multi-period stochastic dynamic programming in a disassembly line context to solve the problem, and generate the best option that will maximize the system total profit. A numerical example is given to illustrate the approach. Finally, directions for future research are suggested.

scholarly journals CURRENT STATUS AND CURRENT PROBLEMS OF THE CONSUMER GOODS DELIVERY BY AUTOMOBILE TRANSPORT IN CITIES

2020 ◽  
Vol 3 (156) ◽  
pp. 17-21
Author(s):  
V. Nefyodov ◽  
O. Kalinichenko
Keyword(s):  
Supply Chain ◽  
Inventory Management ◽  
Consumer Goods ◽  
Influential Factors ◽  
Retail Trade ◽  
Current Status ◽  
Organization Management ◽  
Goods Market ◽  
Long Time ◽  
Quantitative Changes

In a market economy, it becomes relevant to improve the organization management. The aim of solving this problem is to reduce the cost of production in order to increase its sales and increase competitiveness in the consumer goods market. The current state of retail trade in Ukraine in terms of the enterprises development their shares in the total volume of trade, the use of business organization advanced principles, experts assess as rapidly developing. Even modern crisis phenomena in the economy are not of the nature that can change the trends in the qualitative transformations of retail trade. The article analyzes the consumer goods market in Ukraine, which is developing most dynamically. It was found that the consumer goods market capacity has more than tripled recently and has a steady tendency towards further growth. At the same time, in addition to quantitative changes, this market is undergoing qualitative changes, which consist in changing the ratio between food and non-food products, as well as in changing the share of trade enterprises commodity circulation. Existing approaches to organizing the supply chain, based on the idea of turnover as a continuous flow of materials, cannot provide the necessary efficiency of the supply chain due to the fact that they do not take into account very influential factors, such as the relatively long time between adjacent deliveries, the likelihood of a return on the products share and forwarding batch supplies. Therefore, the most appropriate is the presentation by the material flow of consumer goods as a partially ordered movement of goods individual discrete components, which are significantly influenced by both internal (rationalization of marketing and logistics assets in the promotion of material flows, rationalization of inventory management systems, the need for redistribution of stocks between parts of the supply chain), and external (competitive environment, social and geopolitical factors, level of service) factors. Keywords: consumer goods, delivery, automobile transport.

scholarly journals Comparative Cost Analysis of Using Pedi-packs and Adult Red Cell Packs in Newborn Intensive Care Units in Southern Iran

2020 ◽  
Author(s):  
Sezaneh Haghpanah ◽  
Shima Miladi ◽  
Ali Zamani ◽  
Ali Mohammad Keshtvarz Hesam Abadi ◽  
Marjan Gholami ◽  
...  
Keyword(s):  
Developing Countries ◽  
Intensive Care ◽  
Cost Effectiveness ◽  
Cost Analysis ◽  
Exposure Risk ◽  
Tertiary Referral Hospital ◽  
Cross Sectional ◽  
Southern Iran ◽  
Newborn Intensive Care ◽  
Donor Exposure

Abstract Background and objective:In most developing countries, blood transfusions are routinely administered by adult red blood cells (RBCs) packs in infants leading to wastage of a large amount of blood supplies as well as having high donor exposure risk. We aimed to compare the cost-effectiveness of hypothetical pediatric pack compared to adult RBCs pack in neonates.Methods: In this cross-sectional study, all transfused neonates (n = 70) who were admitted to the newborn intensive care unit (NICU) of Nemazee Hospital, a tertiary referral hospital in Shiraz, Southern Iran, were evaluated between March and June, 2019. Based on the blood bank information during the study period and transfusion indices, a specific pediatric pack was suggested and cost-effectiveness of new and traditional transfusion methods was compared.Results: Considering the mean number of transfusions per neonate: 3.57 and mean volume of transfused packed red cells: 20 ml per transfusion during the study period; a quadruple pediatric pack (240 ml divided in 4 sub-packs) was purposed and cost-analysis of pediatric and adult pack was performed. Mathematically, we proved higher cost-effectiveness in using pediatric versus adult pack. Additionally, using pediatric packs leads to 13.74% reduction in RBCs wastage per transfusion and 68.13% reduction in donor exposure rate.Conclusions: Assignment of dedicated pediatric pack for infants will be able to substantially reduce donor exposure risk as well as wasted resources leading to higher cost effectiveness. This finding should be taken into consideration especially in developing countries in order to promote both economic situation and child health status.

scholarly journals The 4-Year Experience with Implementation and Routine Use of Pathogen Reduction in a Brazilian Hospital

Pathogens ◽  
2021 ◽  
Vol 10 (11) ◽  
pp. 1499
Author(s):  
Roberta Maria Fachini ◽  
Rita Fontão-Wendel ◽  
Ruth Achkar ◽  
Patrícia Scuracchio ◽  
Mayra Brito ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Inventory Management ◽  
Age Distribution ◽  
Blood System ◽  
Blood Component ◽  
Production Inventory ◽  
Before And After ◽  
Blood Utilization ◽  
Pathogen Reduction ◽  
Transfusion Reactions

(1) Background: We reviewed the logistics of the implementation of pathogen reduction (PR) using the INTERCEPT Blood System™ for platelets and the experience with routine use and clinical outcomes in the patient population at the Sírio-Libanês Hospital of São Paulo, Brazil. (2) Methods: Platelet concentrate (PC), including pathogen reduced (PR-PC) production, inventory management, discard rates, blood utilization, and clinical outcomes were analyzed over the 40 months before and after PR implementation. Age distribution and wastage rates were compared over the 10 months before and after approval for PR-PC to be stored for up to seven days. (3) Results: A 100% PR-PC inventory was achieved by increasing double apheresis collections and production of double doses using pools of two single apheresis units. Discard rates decreased from 6% to 3% after PR implementation and further decreased to 1.2% after seven-day storage extension for PR-PCs. The blood utilization remained stable, with no increase in component utilization. A significant decrease in adverse transfusion events was observed after the PR implementation. (4) Conclusion: Our experience demonstrates the feasibility for Brazilian blood centers to achieve a 100% PR-PC inventory. All patients at our hospital received PR-PC and showed no increase in blood component utilization and decreased rates of adverse transfusion reactions.

scholarly journals A cost-analysis study of using adult red cell packs and Pedi-Packs in Newborn Intensive Care Units in Southern Iran

2021 ◽  
Author(s):  
Sezaneh Haghpanah ◽  
Shima Miladi ◽  
Ali Zamani ◽  
Ali Mohammad Keshtvarz Hesam Abadi ◽  
Marjan Gholami ◽  
...  
Keyword(s):  
Intensive Care ◽  
Cost Analysis ◽  
Substantial Reduction ◽  
Public Health Issue ◽  
Exposure Rate ◽  
Tertiary Referral Hospital ◽  
Southern Iran ◽  
Newborn Intensive Care ◽  
The Cost ◽  
Donor Exposure

Abstract Background and objective: Saving blood products is an important public health issue especially in developing countries with limited financial resources. We aimed to suggest a new hypothetical model to make a change in the current blood transfusion policy in the newborn intensive care unit (NICU) to reduce wastage of blood supplies as well as the risk of exposure to multiple donors. Methods: In this cross-sectional study, all transfused neonates (n=70) who were admitted to NICU of Nemazee Hospital, a tertiary referral hospital in Southern Iran, were evaluated between March and June 2019. Based on the information of neonates’ transfusion during this study period and determined transfusion indices, a specific pediatric pack was suggested and the related total costs per transfusion, as well as the donor-exposure rate of the hypothetical and the current transfusion method, were compared. Results: Considering the mean number of transfusions per neonate: 4 and mean volume of transfused packed red cells: 20 ml per transfusion, the cost-analysis of pediatric and the adult pack was presented. Arithmetically, we proved a higher total cost per transfusion for using adult pack comparing to pediatric pack. Additionally, using a pediatric pack set leads to a 24% reduction in RBCs wastage per transfusion and a 68.13% reduction in donor-exposure rate.Conclusions: The assignment of a dedicated pediatric pack for neonates will be able to improve the cost-effectiveness by a substantial reduction in donor-exposure rate and blood wastage. This finding should be taken into consideration to generate economic growth and make improvements in child health status.

scholarly journals Under- and over-investment in education: the role of locked-in fertility

2021 ◽  
Author(s):  
Masao Nakagawa ◽  
Asuka Oura ◽  
Yoshiaki Sugimoto
Keyword(s):  
Resource Allocation ◽  
Family Size ◽  
Financial Burden ◽  
Learning Opportunities ◽  
Redistributive Policy ◽  
Fertility Decisions ◽  
Education Investment ◽  
Heavy Financial Burden

AbstractThis research argues that, in the presence of idiosyncratic ability shocks after childbirth, irreversible fertility decisions distort the resource allocation between the quantity and quality of children. In underdeveloped environments, where family size is locked into large levels, education investment places a heavy financial burden on households, which deprives some competent children of learning opportunities. In contrast, in more developed environments, family size is locked into smaller levels, which facilitates education investment even for some children with low aptitude. A redistributive policy to mitigate the distortion is proposed for each stage.

scholarly journals Development of a Calibrated Simulation Method for Airborne Particles to Optimize Energy Consumption in Operating Rooms

Energies ◽  
2019 ◽  
Vol 12 (12) ◽  
pp. 2433 ◽  
Author(s):  
Febrero-Garrido ◽  
López-González ◽  
Eguía-Oller ◽  
Granada-Álvarez
Keyword(s):  
Operating Room ◽  
Particle Concentration ◽  
Energy Savings ◽  
Simulation Method ◽  
Operating Rooms ◽  
Influential Factors ◽  
Airborne Particles ◽  
Airborne Particle ◽  
Controlled Environments ◽  
Calibrated Simulation

Operating rooms are stringent controlled environments. All influential factors, in particular, airborne particles, must be within the limits established by regulations. Therefore, energy efficiency stays in the background, prioritizing safety and comfort in surgical areas. However, the potential of improvement in energy savings without compromising this safety is broad. This work presents a new procedure, based on calibrated simulations, that allows the identification of potential energy savings in an operating room, complying with current airborne particle standards. Dynamic energy and airborne particle models are developed and then simulated in TRNSYS and calibrated with GenOpt. The methodology is validated through experimental contrast with a real operating room of a hospital in Spain. A calibrated model with around 2% of error is achieved. The procedure determines the variation in particle concentration according to the flow rate of ventilation supplied and the occupancy of the operating room. In conclusion, energy savings up to 51% are possible, reducing ventilation by 50% while complying with airborne particles standards.

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