Discarded cellular components and the technical efficiency of component preparation.

Given increasing cost pressures, the need to improve the technical efficiency of the production chain used for collected blood in blood banking should be recognised. Data envelopment analysis (DEA) was used to study the relationship between discard rates and technical efficiency. Whole-blood (WB) collections, aphaeresis-platelets, produced and discarded red blood cells (RBCs) and platelets (PLTs) were included in the analyses. Technical efficiency tended to be higher when the proportion of the total of RBC and PLT discards from WB collections was low. In DEA modelling, the choice of relevant input and output variables is one of the most important factors affecting the validity of the results. Discarded components should not be ignored in analyses of efficiency, because lost production output also has monetary value.

International comparison of the technical efficiency of component preparation.

BACKGROUND: Under economical constraints, blood centers need to identify ways to improve their efficiency. Because there is little evidence regarding the technical efficiency of blood centers, international comparisons may be useful in identifying efficiency discrepancies and can reveal opportunities for enhancing efficiency, such as allocating resources more effectively. STUDY DESIGN AND METHODS: Data were collected for years 2000 through 2002 from 16 blood centers in 10 European countries. Input variables included working hours, whole-blood (WB) collections, premises, and equipment, and the output variables were red blood cells and platelets (PLTs). A nonparametric method, data envelopment analysis (DEA), was used in the analyses of technical efficiency in blood component preparation departments. Efficiency scores were calculated with DEA linear programming techniques and evaluated for site characteristics that possibly affect efficiency, such as the production method of PLTs and the proportion of BCs (buffy coats) from WB and BC PLTs from all PLTs produced. RESULTS: With working hours and equipment as inputs, median technical efficiency was 60 percent (range, 41%-100%). Four departments were efficient (efficiency, > 90%), and 12 were inefficient (range, 41-89). Efficiency remained roughly the same in 13 departments through the 3-year study period and decreased in 3. Efficiency was mainly affected by staffing levels (working hours). Efficiency did not directly relate to production volume, method, or any other site characteristic. CONCLUSIONS: The major cause of inefficiency was excess staffing resulting from a suboptimal combination of manpower and production output levels. Further research is needed to manage factors affecting efficiency, such as the fluctuation of demand in production planning.

Variation of platelet production and discard rates in 17 blood centers representing 10 European countries from 2000 to 2002.

BACKGROUND: New blood safety regulations raise costs and pressure blood centers to improve their efficiency. Evaluation of platelet (PLT) production and discards between centers of different size and nationality may provide a basis for more efficient PLT inventory management. STUDY DESIGN AND METHODS: Data were gathered retrospectively for 2000 to 2002 from 17 blood centers in 10 European countries. The descriptive analyses comprised evaluation of PLT production methods and volumes. Discard rates were surveyed also for 2003 to 2004. The number of cellular blood components produced per working hour was expressed as an arbitrary labor index. RESULTS: Seven hospital blood banks and 10 centers with other administrative systems participated in the study. Buffy coat (BC) and apheresis PLTs were used by all centers except two preparing all PLTs by apheresis. In 2002, 73 percent of all PLTs were produced by the BC method, and PLTs were utilized from 41 percent of whole-blood donations. One center also produced PLTs by the PLT-rich plasma method. Mean annual production volume of PLTs varied greatly, from 3,345 to 103,643 units, with an increase of 5.6 percent from 2000 to 2002. Three-year mean discard rates varied between 6.7 and 25 percent, and yearly mean discard rates remained at 13 percent in 2000 to 2002 and also in 2003 to 2004. Arbitrary labor index varied from 2.4 to 7.3 between centers. CONCLUSIONS: PLT discard rates were relatively high in the European blood centers. Detailed information on specific causes for high discard rates would help improve the efficiency of PLT management, because blood centers cannot regulate demand. Use of labor resources in component preparation also remains an important target for further research.