[Work organisation improvement methods applied to activities of Blood Transfusion Establishments (BTE): Lean Manufacturing, VSM, 5S]. / Méthodes d'amélioration organisationnelle appliquées aux activités des établissements de transfusion sanguine (ETS): Lean manufacturing, VSM, 5S.

BACKGROUND: Continuous improvement of efficiency as well as new expectations from customers (quality and safety of blood products) and employees (working conditions) imply constant efforts in Blood Transfusion Establishments (BTE) to improve work organisations. METHODS: The Lean method (from "Lean" meaning "thin") aims at identifying wastages in the process (overproduction, waiting, over-processing, inventory, transport, motion) and then reducing them in establishing a mapping of value chain (Value Stream Mapping). It consists in determining the added value of each step of the process from a customer perspective. Lean also consists in standardizing operations while implicating and responsabilizing all collaborators. The name 5S comes from the first letter of five operations of a Japanese management technique: to clear, rank, keep clean, standardize, make durable. The 5S method leads to develop the team working inducing an evolution of the way in the management is performed. RESULTS: The Lean VSM method has been applied to blood processing (component laboratory) in the Pays de la Loire BTE. The Lean 5S method has been applied to blood processing, quality control, purchasing, warehouse, human resources and quality assurance in the Rhône-Alpes BTE. The experience returns from both BTE shows that these methods allowed improving: (1) the processes and working conditions from a quality perspective, (2) the staff satisfaction, (3) the efficiency. CONCLUSIONS: These experiences, implemented in two BTE for different processes, confirm the applicability and usefulness of these methods to improve working organisations in BTE.

[Transfusion of concentrates enriched in neocytes in the thalassemic child. Preliminary results]. / Transfusion de concentrés enrichis en néocytes chez l'enfant thalassémique. Résultats préliminaires.

In this study, we compared the results of young red cells transfusion for 12 months with the administration of conventional red cells units during the year before, in three thalassemic children. We used the Neocel system (Cutter laboratories) to prepare neocytes. A quality control of neocyte units was developed: especially the phthalate oil technique which shows a 70% enrichment of young red cells. These patients received 170.4 +/- 9 ml/kg of body weight of neocytes compared with 197 +/- 20 ml/kg of body weight of conventional red cells concentrates. The mean decrease of hemoglobin transfused per kg of body weight per year was 22%. The mean pretransfusion hemoglobin level did not change during the 2 years of study. The children grow without any problem and no pathologic event occurred during the study. The control of the serological ferritin levels does not allow for definitive conclusions in the evolution of the iron overload of our three patients. However, this overload seems to decrease. It's why it's necessary to carry on with our study.