Transcript National Centralized Blood System

National Centralized
Blood System
By:
Ahmad Gharehbaghian MTD, PhD
(Faculty member of Iranian Blood Transfusion
Organization)
‫مركز تحقيقات‬
First Meeting of Blood Services Directors of ECO Member States, 23-25 June 2008, Tehran-Iran
Basic Concept
Have one organization provide the
blood transfusion services for multiple
hospitals
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Basic functions of a blood
transfusion centre
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Management of services
Recruitment of donors
Collection, processing, storage and distribution
of blood and blood components
Laboratory investigations
Participation in clinical use of blood and blood
components
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Teaching and training
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Research and development
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The Need
The Need for blood supplies
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Transfusion of blood and blood products: an
integral and essential part of patient
management
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Timely and equitable access to safe blood &
blood components for all patients whose lives
depend on this treatment modality
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What is big challenge in blood
adequacy and safety?
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Lack of national or organized blood transfusion
service program
Lack of safe voluntary unpaid blood donors or
small size of donors pool
Insufficient blood supply
Unscreened blood
Inappropriate use of blood products
Lack of or inadequate basic QC plan
Inadequate support by stockholders
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WHO report in developing countries about
blood transfusion
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81 million blood units collected globally every
year at a cost of at least 7.5 billion USD
80% of the world has access to 20% of safe
global blood supply
139 countries do not have 100% voluntary
donation
6 million tests are not done on donated blood
>50% countries lack quality systems and
reliable supply of reagents
Up to 50% transfusions are unnecessary
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Important roles of the national blood
program
1. Advocacy and resource mobilization
2. Collaboration with state, regional centers
and NGOs
3. Development of technical guidelines and
SOPs
4. Institution of a monitoring and evaluation
mechanism for quality management
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Important roles (continued)
5. Identification of referral centers
6. Promotion of research and development
7. Development
of
a
plan
for
disaster
management
8. Establishment of fractionation policies
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Advantages of Centralized Blood
Systems
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Cost reductions
- High-volume testing
- High-volume purchasing leading to cost savings
- Centralized delivery of transfusion services leading
to financial savings
Appropriate use of transfusion experts and senior staff
Improved quality by nation-wide standardization
Improved resource management
Increased efficiency
Development of a core of transfusion medicine
specialists
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Advantages (continued)
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Encouragement of the exchange, standardization,
and optimization of transfusion practice
Establishment of a centralized database of patient
transfusion history and specialized blood component
requirements
Centralized nation-wide database of patient
transfusion history
Establishment of transfusion medicine specialists as a
community resource
Staff efficiency
Implementation of appropriate strategy in disasters
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Advantages (continued)
13. Delivery of specialized transfusion medicine services to any size
hospital
- Coagulation factor concentrates, albumin, IVIG and related plasma
derivatives
- Specialized component processing or testing: leukoreduced
products, CMV and other virus-safe products, irradiated
components, washed and volume-reduced components
14. Centralized management of blood resources across the whole nation
15. Report of adverse reactions and errors
16. Use of automate and computerized system
17. Active involvement of blood centers in clinics and hospitals
18. Exact centralized oversight (error management)
19. Encouragement of end-users to cooperate with blood centers
20. Reduction of inappropriate blood prescriptions & blood orders review
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Centralization of blood donor
programs
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Uniform policies and functions for:
- Recruitment of donors
- Motivation of donors
- Education of donors
- Maintains of donors
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Disadvantage of Centralized Blood Systems:
It may require a large inventory and face transport problems.
Decentralized Systems:
It may be more practical
but
problems related to uniformity of services, cost-efficiency and
quality management.
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Which model?
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There is not one model that suits all countries
Each country needs to study its healthcare
organization, its infrastructure, resources as well as
its size, geography, and the population it serves.
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Experiences on Centralization
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Some blood services in
Latin American countries and
European, UK, France
Canada, Australia
New Zealand, Albania,
Bhutan, Cambodia,
Malaysia, the Philippines,
Vietnam and Iran
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Iranian Blood Transfusion
Organization
The only nationally accredited organization in Iran that
performs blood transfusion procedures ranging from
blood donor recruitment to blood distribution
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Iranian Blood Transfusion
Organization
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IBTO is a single nonprofit organization (Iranian Blood
Transfusion Organization) which is responsible for the
nation’s blood supply and was established in 1974.
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IBTO is a national and centralized organization with
blood centers across Iran in all provinces and main
cities.
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There are roughly 200 fixed blood collection centres
out of which 65 embark both on blood components
preparation, testing, and release; the other 17 out of
the total number embark just on collection and
preparation with no testing.
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IBTO's High Council
Managing Director
Department of
Legal Affairs
Department of
Public Relation &
International Affairs
Deputy of
Management
Expansion &
Improvement
Security Office
Office of Activity
Evaluation &
Complaints
Deputy of Technical
& Quality Assurance
Managing
Director Office
Deputy of Research
& Development
Technical Department
Director of Renovation &
Administrative
Improvement
Department of
Administrative Affairs
Department of Financial
Affairs
Department of Supply,
Maintenance & Services
for Medical Equipments
IBTO organizational chart
Quality Assurance
Department
Blood Donors Education
& Recruitment
Department
Occupational Safety &
Health Department
Regional blood
transfusion
centers
Department of
Research
Department of
Education
Research Center
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Population: 68,920,000, Total area: 1,648,000 sq. km
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Screening process ranging from proper donor
selection to consultation session is precisely followed
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All deferral criteria are observed
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All screening tests are conducted
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No blood banks in hospitals collect blood
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Blood products are provided to hospitals free of
charge
- No charges or fees are requested for the cost of collecting,
testing, processing, storing and shipping the blood.
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IBTO: National/Centralized &
Regional/Decentralized?!
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SOPs and guidelines,
evaluation policies,
external QC,
purchasing of screening kits, blood bags, major
equipment and devices including refrigerated
centrifuges, blast freezers, automated instruments or
group typing tools
Blood donor recruitment policies except for some
deviations cause of regional and provisional cultural
and social status
Research and teaching
Iranian blood transfusion organization-Research centre
IBTO: National/Centralized &
Regional/Decentralized?!
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Need assessment meeting community blood demands
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Screening tests
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Preparation of blood components
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Blood components dispatching
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Budgeting and finance
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IBTO: Regional/Decentralized?!
Testing and distribution of blood components
Why?
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 Transport problems
 Largeness of the country
 Extensive scope of universities of medical
sciences
 Availability of specialized wards in regional
hospitals e.g. transplantation or heart surgery, ...
 Immediate need for blood transfusion
 The vital need of special patients such as
thalassemics in different provinces
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Thanks, wish you all a happy stay in Iran
Rate of Blood Donation 1997-2007
2000000
1800000
1600000
1400000
Count
1200000
1000000
800000
600000
400000
200000
0
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
Year
Iranian blood transfusion organization-Research centre
The blood compone nts pre paration rate 1997-2007
1800000
1600000
1400000
1200000
1000000
800000
600000
400000
200000
0
1997
W.B
1998
P.C
1999
2000
Plt.
2001
2002
FFP
2003
2004
2005
2006
2007
Cryoprecipitate
Iranian blood transfusion organization-Research centre
IBTO Research Center 2003
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IBTO-Research Centre has published more than 70
specialized educational pamphlets and 20 books about blood
transfusion, blood safety, and transfusion sciences in Farsi
language in last 4 years.
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IBTO-Research Centre embarked on publishing its specialized
quarterly entitled “Khoon” (Blood) that is indexed by IMEMR
and Index Copernicus.
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We forward copies of all our pamphlets, books, and journals to
WHO and EMRO so as to be used in Farsi-speaking
communities (such as Afghanistan). IBTO hopefully won the
status of being a WHO Collaborating Center.
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Mixed System
Hospital based centers and regional centers
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