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Anna Nagurney - One of the best experts on this subject based on the ideXlab platform.
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multitiered Blood supply chain network competition linking Blood Service organizations hospitals and payers
2019Co-Authors: Pritha Dutta, Anna NagurneyAbstract:In this paper, we present a multi-tiered competitive supply chain network model for the Blood banking industry, with a focus on the United States, that captures the economic interactions between three tiers of stakeholders; namely, the Blood Service organizations, the hospitals or medical centers, which transfuse Blood to patients, and the payer groups that patients belong to. In addition, the supply chain framework for this life-saving product includes the competition among Blood Service organizations and their various supply chain activities. We model the behavior of each category of stakeholder and use the theory of variational inequalities to derive the equilibrium conditions for the entire supply chain. Illustrative examples are provided, along with qualitative properties, followed by an algorithm, accompanied by convergence results, that is used to solve simulated numerical examples. Results from these examples demonstrate that such a model can be effectively used to determine the prices and Blood pathways from Blood Service organizations to hospitals to payers.
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Supply chain network competition among Blood Service organizations: a Generalized Nash Equilibrium framework
2019Co-Authors: Anna Nagurney, Pritha DuttaAbstract:In this paper we present a Generalized Nash Equilibrium model of supply chain network competition among Blood Service organizations which compete not only for Blood donors but also for business from hospitals and medical centers. The model incorporates not only link capacities and associated arc multipliers to capture perishability, but also bounds on the number of donors in regions as well as lower and upper bounds on the demands at the demand points in order to ensure needed amounts for surgeries, treatments, etc., while reducing wastage. The concept of a variational equilibrium is utilized to transform the problem into a variational inequality problem, and alternative formulations are given. A Lagrange analysis yields economic insights. The proposed algorithmic procedure is then applied to a series of numerical examples in order to illustrate the impacts of disruptions in the form of a reduction on the number of donors as well as that of decreases in capacities of critical links such as testing and processing on RBC prices, demands, net revenues of the Blood Service organizations, and their overall utilities.
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supply chain network operations management of a Blood banking system with cost and risk minimization
2012Co-Authors: Anna Nagurney, Amir H MasoumiAbstract:Blood Service operations are a key component of the healthcare system all over the world and yet the modeling and the analysis of such systems from a complete supply chain network optimization perspective have been lacking due to their associated unique challenges. In this paper, we develop a generalized network optimization model for the complex supply chain of human Blood, which is a life-saving, perishable product. In particular, we consider a regionalized Blood banking system consisting of collection sites, testing and processing facilities, storage facilities, distribution centers, as well as points of demand, which, typically, include hospitals. Our multicriteria system-optimization approach on generalized networks with arc multipliers captures many of the critical issues associated with Blood supply chains such as the determination of the optimal allocations, and the induced supply-side risk, as well as the induced cost of discarding the waste, while satisfying the uncertain demands as closely as possible. The framework that we present is also applicable, with appropriate modifications, to the optimization of other supply chains of perishable products.
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supply chain network operations management of a Blood banking system with cost and risk minimization
2011Co-Authors: Anna Nagurney, Amir H MasoumiAbstract:Blood Service operations are a key component of the healthcare system all over the world and yet the modeling and analysis of such systems from a supply chain network optimization perspective has been lacking due to their associated unique challenges. In this paper, we develop a network optimization model for the complex supply chain of human Blood, which is a life-saving, perishable product. In particular, we consider a regionalized Blood banking system consisting of collection sites, testing and processing facilities, storage facilities, distribution centers, as well as points of demand, which, typically, include hospitals. Our multicriteria system-optimization approach on generalized networks with arc multipliers captures many of the critical issues associated with Blood supply chains such as the determination of the optimal allocations, and the induced supply-side risk, as well as the induced cost of discarding the waste, while satisfying the uncertain demands as closely as possible. The framework that we present is also applicable, with appropriate modifications, to the optimization of other supply chains of perishable products.
Frederica Farneti - One of the best experts on this subject based on the ideXlab platform.
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ic reporting in the australian red cross Blood Service
2009Co-Authors: James Guthrie, Peter Steane, Frederica FarnetiAbstract:Purpose – The paper aims to study and compare the Australian Red Cross Blood Service (ARCBS) annual (AR) and intellectual capital reports (ICR) with an earlier study. The paper seeks to analyse the reporting practices of intellectual capital (IC) within this organisation.Design/methodology/approach – The case study organisation is an Australian not‐for‐profit (NFP) organisation and the study took place over three years. A content analysis of ARCBS AR and ICR between 2002 and 2005 was conducted. Several interviews were conducted with a number of key ARBCS staff during 2006 to identify why and how they reported IC information.Findings – The findings indicate a greater focus on internal and external capital with less focus on human capital. The frequency with which certain internal, external and human capital elements occur in ARCBS reports can be explained by macro, meso and micro factors which affect the organisation and influence the information it provides to its stakeholders. It was found that the AR ad...
Lorna M Williamson - One of the best experts on this subject based on the ideXlab platform.
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the eastr study indications for transfusion and estimates of transfusion recipient numbers in hospitals supplied by the national Blood Service
2009Co-Authors: A W Wells, C A Llewelyn, Angela C Casbard, A J Johnson, Mohammad Amin, Sian Ballard, Jackie Buck, M Malfroy, Michael F Murphy, Lorna M WilliamsonAbstract:This study provides data on National Blood Service (NBS) red Blood cell (RBC, n = 9142), platelet (PLT, n = 4232) and fresh frozen plasma (FFP, n = 3584) recipients independently sampled by monthly quota from 29 representative hospitals over 12 months in 2001–2002. Hospitals were stratified by size according to total yearly RBC issues. Transfusion indications were chosen from diagnostic and procedural codes, and recipients grouped into Epidemiology and Survival of Transfusion Recipients Case-mix Groups (E-CMGs). The main E-CMGs were digestive [19% of RBC recipients; including 5% gastrointestinal (GI) bleeds and 3% colorectal surgery], musculoskeletal (15%; 12% hip and knee replacement), haematology (13%) and obstetrics and gynaecology (10%). Renal failure, fractured neck of femur, cardiac artery by-pass grafting (CABG) and paediatrics, each accounted for 3–4% recipients. FFP recipients: the main E-CMGs were digestive (21% of FFP recipients; including 7% GI bleeds and 3% colorectal surgery), hepatobiliary (15%; 7% liver disease and 2% liver transplant), cardiac (12%) and paediatrics (9%) The renal, paediatrics, vascular and haematology E-CMGs each had 6–7% of recipients. PLT recipients: the main E-CMGs were haematology (27% of PLT recipients; including 9% lymphoma and 8% acute leukaemia), cardiac (17%), paediatrics (13%), hepatobiliary (10%) and digestive (9%). Back-weighting gave national estimates of 433 000 RBC, 57 500 FFP and 41 500 PLT recipients/year in England and North Wales, median age 69, 64 and 59 years, respectively. Digestive and hepatobiliary indications emerged as the top reason for transfusion in RBC and FFP recipients, and was also a frequent indication in PLT recipients.
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national Blood Service trali reduction policies implementation and effect
2008Co-Authors: Catherine E Chapman, Lorna M WilliamsonAbstract:This article describes the TRALI reduction policies which were introduced by the National Blood Service in late 2003. Consideration was given to the reasons for their introduction and how the changes
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value of central analysis of leucocyte depletion quality control data within the national Blood Service england
2002Co-Authors: Neil Beckman, Lorna M Williamson, Rebecca Cardigan, T WallingtonAbstract:Background and Objectives The results of quality monitoring leucocyte counts were analysed nationally for the first 2 years of universal leucocyte depletion (LD), spanning the time-period before and after standardization of the counting and LD methods. The objectives were twofold: first to determine whether the implementation strategy was effective in achieving the LD specification (< 5 × 106 leucocytes in 99% of components with 95% statistical confidence); and second, whether quality monitoring was able to detect potential non-conformance. Materials and Methods Residual leucocytes were counted using Beckman Coulter or Becton Dickinson (BD) flow cytometers and reagents. Data were collected into standardized analysis software (NWA Quality Analyst) for local trend analysis and checks for conformance to process specification, and collated centrally. Analysis was performed for six time-periods between January 1999 and March 2001. Specification failures were analysed to determine the likelihood of extreme failure. Statistical process monitoring was adjusted to suit LD processes. Results Data from red cells in optimal additive solution (OAS), filtered either as whole Blood or red cell concentrates, and platelet pools improved significantly over the 2-year period with specification failures falling from 0·35%, 0·48% and 0·56%, respectively, in January–June 1999 to 0·06%, 0·01% and 0·04% in January–March 2001. Specification failures in red cells in OAS LD for the period January–December 2000 showed only 0·02% with a leucocyte count of > 30 × 106/unit. Extreme failures are now very rare. Monitoring methods have been effective in detecting process change and drift. Conclusion LD performance varies between different LD systems, but monitoring has proved sufficiently robust to detect processes that perform poorly. The chosen specification has been both achievable and appropriate to the systems in use. Standardization of the counting method is central to the ability to monitor and analyse results effectively across the whole Service.
Pritha Dutta - One of the best experts on this subject based on the ideXlab platform.
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multitiered Blood supply chain network competition linking Blood Service organizations hospitals and payers
2019Co-Authors: Pritha Dutta, Anna NagurneyAbstract:In this paper, we present a multi-tiered competitive supply chain network model for the Blood banking industry, with a focus on the United States, that captures the economic interactions between three tiers of stakeholders; namely, the Blood Service organizations, the hospitals or medical centers, which transfuse Blood to patients, and the payer groups that patients belong to. In addition, the supply chain framework for this life-saving product includes the competition among Blood Service organizations and their various supply chain activities. We model the behavior of each category of stakeholder and use the theory of variational inequalities to derive the equilibrium conditions for the entire supply chain. Illustrative examples are provided, along with qualitative properties, followed by an algorithm, accompanied by convergence results, that is used to solve simulated numerical examples. Results from these examples demonstrate that such a model can be effectively used to determine the prices and Blood pathways from Blood Service organizations to hospitals to payers.
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Supply chain network competition among Blood Service organizations: a Generalized Nash Equilibrium framework
2019Co-Authors: Anna Nagurney, Pritha DuttaAbstract:In this paper we present a Generalized Nash Equilibrium model of supply chain network competition among Blood Service organizations which compete not only for Blood donors but also for business from hospitals and medical centers. The model incorporates not only link capacities and associated arc multipliers to capture perishability, but also bounds on the number of donors in regions as well as lower and upper bounds on the demands at the demand points in order to ensure needed amounts for surgeries, treatments, etc., while reducing wastage. The concept of a variational equilibrium is utilized to transform the problem into a variational inequality problem, and alternative formulations are given. A Lagrange analysis yields economic insights. The proposed algorithmic procedure is then applied to a series of numerical examples in order to illustrate the impacts of disruptions in the form of a reduction on the number of donors as well as that of decreases in capacities of critical links such as testing and processing on RBC prices, demands, net revenues of the Blood Service organizations, and their overall utilities.
Marion Vermeulen - One of the best experts on this subject based on the ideXlab platform.
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assessment of hiv transfusion transmission risk in south africa a 10 year analysis following implementation of individual donation nucleic acid amplification technology testing and donor demographics eligibility changes
2019Co-Authors: Marion Vermeulen, Nico Lelie, Charl Coleman, Wendy Sykes, Genevieve Jacobs, Ronel Swanevelder, Michael P Busch, Gert U Van Zyl, Eduard GrebeAbstract:BACKGROUND In 1998 we estimated that 34/million infectious window period donations were entering the Blood supply at the South African National Blood Service. Selective use of donations based on donor race-ethnicity reduced this risk to 26/million donations but was deemed unethical. Consequently, in 2005 South African National Blood Service eliminated race-ethnicity-based collection policies and implemented individual-donation nucleic acid testing (ID-NAT). We describe the change in donor base demographics, human immunodeficiency virus (HIV) detection rates, and transfusion-transmissible HIV risk. STUDY DESIGN AND METHODS In ten years 7.7 million donations were tested for anti-HIV and HIV RNA. Number of donations, HIV prevalence, ID-NAT yield rate, serology yield rate and residual transfusion-transmissible HIV risk were analyzed by donor type, race-ethnicity, age, and sex. Multiple regression analysis was performed to investigate the determinants of HIV-positive and nucleic acid testing yield donations. RESULTS The combined strategy of increasing donations from black donors and implementing ID-NAT increased the proportion of donations from black donors from 6% in 2005 to 30% in 2015 (p < 0.00001), and reduced the transfusion-transmissible risk from 24 to 13 per million transfusions. ID-NAT interdicted 481 (1:16,100) seronegative window period donations, while one transfusion-transmissible case (0.13 per million) was documented. Race-ethnicity and donor type were highly significant predictors of HIV positivity, with adjusted odds ratio for first-time donors of 12.5 (95% confidence interval, 11.9-13.1) and for black race-ethnicity of 31.1 (95% confidence interval, 28.9-33.4). The proportion of serology yields among HIV-infected donors increased from 0.27% to 2.4%. CONCLUSION ID-NAT enabled the South African National Blood Service to increase the number of donations from black donors fivefold while enhancing the safety of the Blood supply.
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hepatitis b virus transmission by Blood transfusion during 4 years of individual donation nucleic acid testing in south africa estimated and observed window period risk
2012Co-Authors: Marion Vermeulen, Nico Lelie, Charl Coleman, Robert Crookes, Ravi Reddy, Caroline Dickens, Evangelia Walker, Mark Keyter, Anna KramvisAbstract:BACKGROUND: Since October 2005, a total of 2,921,561 Blood donations have been screened by the South African National Blood Service for hepatitis B virus (HBV) by individual-donation nucleic acid testing (ID-NAT). Over 4 years, 149 hepatitis B surface antigen–negative acute-phase HBV NAT–positive donations were identified (1:19,608). The lookback program identified one probable HBV transmission. STUDY DESIGN AND METHODS: The complete genomes of HBV isolated from the donor and recipient were sequenced, cloned, and analyzed phylogenetically. The HBV window period (WP) transmission risk was estimated assuming a minimum infectious dose of 3.7 HBV virions and an incidence rate correction factor of 1.34 for transient detectability of HBV DNA. RESULTS: Of 149 acute-phase HBV NAT yields, 114 (1:25,627) were classified as pre–antibody to hepatitis B core antigen (anti-HBc) WP and 35 (1:83,473) as post–anti-HBc WP. The acute-phase transmission risk in the HBV DNA–negative pre- and post–anti-HBc WPs (of 15.3 and 1.3 days, respectively) was estimated at 1:40,000 and 1:480,000, respectively. One HBV transmission (1:2,900,000) was identified in a patient who received a transfusion from an ID-NAT–nonreactive donor in the pre–anti-HBc WP. Sequence analysis confirmed transmission of HBV Subgenotype A1 with 99.7% nucleotide homology between donor and recipient strains. The viral burden in the infectious red Blood cell unit was estimated at 32 (22-43) HBV DNA copies/20 mL of plasma. CONCLUSION: We report the first known case of transfusion-transmitted HBV infection by Blood screened using ID-NAT giving an observed HBV transmission rate of 0.34 per million. The estimated pre–acute-phase transmission risk in the ID-NAT screened donor population was 73-fold higher than the observed WP transmission rate.
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impact of individual donation nucleic acid testing on risk of human immunodeficiency virus hepatitis b virus and hepatitis c virus transmission by Blood transfusion in south africa
2009Co-Authors: Marion Vermeulen, Nico Lelie, Wendy Sykes, Robert Crookes, Johanna Swanevelder, Lilian Gaggia, Martin Le Roux, Eben Kuun, Sam Gulube, Ravi ReddyAbstract:BACKGROUND: In 2005, the South African National Blood Service introduced individual-donation (ID) nucleic acid test (NAT) screening for human immunodeficiency virus (HIV) RNA, hepatitis C virus (HCV) RNA, and hepatitis B virus (HBV) DNA. At the same time the use of ethnic origin to prioritize the transfusion of Blood according to a hierarchy of residual risk was discontinued. STUDY DESIGN AND METHODS: ID-NAT (Ultrio on Procleix Tigris, Chiron) and serology (PRISM, Abbott) repeat test and confirmation testing algorithms were designed to enable differentiation between false-positive and true-NAT and -serology yields. After 1 year, the NAT and serology yield rates in first-time, lapsed, and repeat donors were analyzed and used to estimate the residual risk of HIV, HBV, and HCV infections by Blood transfusion. RESULTS: The HIV, HBV, and HCV ID-NAT window phase yield rates in 732,250 Blood donations were 1:45,765, 1:11,810, and 1:732,200, respectively. Seven of 16 HIV window phase donations with viral loads above 16,000 copies/mL were HIV p24 antigen enzyme-linked immunosorbent assay positive. PRISM detected anti-HIV and hepatitis B surface antigen (HBsAg) in 89.4 and 73.9% of early infections in repeat donors. The Procleix assay detected viremia in 99.7 and 95.5% of anti-HIV– and HBsAg-positive first-time donors. In these donors, the occult HBV DNA carrier rate was 1:5200. The residual transmission risk of ID-NAT HIV, HBV, and HCV window phase donations was estimated at 1:479,000, 1:61,500, and 1:21,000,000 respectively. CONCLUSION: One-year ID-NAT screening of 732,250 donations interdicted 16 HIV, 20 HBV, and 1 HCV window phase donations and 42 anti-hepatitis B core antigen–reactive infections during an early recovery or a later stage of occult HBV infection.