BOOKS OF RtfiDIfGS - PAHO/WHO

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The light pen techniques are also utilized to control computer operations and lo
identify the locations to which blood products are shipped or from wherc they were
received. This is done by scanning bar codes on menu sheets that list all shipping
locations, all types of transactions, and all available types of computer operations.
This way, the computer is effectively used by nontechnical personnel, and any errors
in entering data are minimized.
In order to maintain a modular approach that can be utilized by all RBC's
regardless of size, a network of miniconlpiuters is hcing used to h:ndic aHl the RBC
blood processing needs. In a larger operation, such as LI3BS, thc operations are split
functionally (i.e., separatc miniconiputers in the laboratory and disiribution arcas),
while in the smaller centers a single minicomputer would handle all functions.
Impact, Implications, and extensions
Scientific in¡puct
The successful operation of PBDS at LIBS has demonstrated the ability to set
performance measures on the basis of regional planning. It establishes the first
quantitative management guide for the selection of fcasiblc targets and slrategics. for
the evaluation of options within a class of strategies, and for establishing the best
possible performance within that class as a refercnce for the stratcgy selccted. It
further demonstrates the ability to identify 4eviations from anticipated performance
and, consequently, the ability to manage by exception.
An example of this is the analysis of reported utilization by 28 HBB's that was
performed recently. Statistical techniques indicated that the utilization rate pattern
for 18 of the 28 HBB's were statistically not differentiable and showed an average
utilization rate of 96%, which is close to the 98% value predicted; 6 HBB utilization
rates were indicated as significantly below this norm and 4 utilization rates werc
indicated as significantly above the norm. Since the same utilization rate is achievable
for all HBB's under PBDS, deviations from the statistical norm can be confidently
attributed to assignable causes. The utilization rates above the norm are
attributed to sophisticatd techniques such as holding the same blood unit for several
possible recipients concurrently. The poorer utilization performance of the 6 HBB's
is attributed to poor blood banking practices such as failure to retum untransfused
units to inventory promptly, or to special hospital practices.
Management decision implications
PBDS implies major changes in management decision `models both for the RBC
and the HBB's. Most regions follow a procedure characterized by a decentralized and
reactive distribution. In this mode of operation, the HBB checks its inventory status
one or more times per day and, if it deems it to be low, places an order for additional
blood. The RBC makes a decision whether its inventory is sufficient to fill the order.
If it is, it delivers the requested quantity. If it is not, then it seeks to modify the order
to a lesser amount, to substitute red blood celis for whole blood, etc. This "discussion"
results in a modified order which is actually delivered. Both the HBB and the
INTERFACES November 1979