BOOKS OF RtfiDIfGS - PAHO/WHO

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shipnients have to be on rotation. In practice, however, RBC's can only schedule
between 70% and 85% of the average blood collections for rotation shipments because
of uncertainties in blood availability, and the need to keep an RBC reserve.
Therefore, if thc amnount of rotational blood available for distribution is approximnately
equal to that which will be utilized within the region (i.e., if u strict selfsufficiency
criterion is applied), then for these blood groups either very low
availability or alternatively a very significant rcduction iti utilization must he accepled.
Since neithecr of these alterniatives is desirable, un alternative is to rotate nmore
blood units in this blood groupl thal will be cventually transfused in the region and
redistribute some portion of the returned blood units lo another region utilizing the
inventory balancing techniqLues that wcrc described earlier. This is a feasible approach
in LIBS since, like most regions thal are primarily suburban and rural in
nature, it has the capacity for collecting blood significantly in excess of the overall
regional needs.
LIBS collccts approximaitely 20%/1 more blood than will be ultimately transfuised
in the region. Virtually all of thc rarer bloods are first rotated to HBB's iii the region,
while the excess collection in the more common bloods are mnostly immediately sent
to the New York Blood Services (NYBS) division of GNYBP. This division encoiipasses
the metropolitan New York arca and, like n1ost large urban arcas, has difficulty
in collecting enough blood to nieet the needs of the imajor medical centers anid
other hospitals in this area. The influx from LIBS is of significant help and the small
fraction of older, rarer bloods thilt are reccived as stock-dated units can rcadily he
absorbed. Thus the units collected in LIBS in excess of its own transfusion necds
improves the quality of blood services in LIBS as well as in NYBS. On the other
hand, the major medical centers in the New York Division of GNYBP also serve the
needs of much of the population residing iii the arca covered by LIBS.
It should be noted that not all major regions such as LIBS require interaction
with larger regions. A planning exercise performed for the regional blood center in
Richmond, Virginia, which services only seven HBB's, indicated that this region
was remarkably self-sufficient. This is primarily because it includes a major medical
center which accounts for a significant part of the regional usage. However, for the
most part there is a.mutually beneficial interaction feasible between the smaller
RBC's serving mainly suburban and rural arcas and the larger ones which will mostly
service larger urban areas.
These conclusions suggest that the concept of total regional self-sufficiency
which has long prevailed in blood banking is in conflict with the goals of the Nutional
Blood Policy that calis for high availability with efficiency. Rather, a modest level of
resource sharing between regions as outlined above will work to the benefit of all
participants.
Extensions
The success of PBDS has fostered a favorable climate for the further application
of Management Science techniques both on a national and international basis. Thc
International Society of Blood Transfusion Expert Committee on Automation has
INTERFACES November 1979