Transcript Sanquin Corporate Presentation

Creating a Consolidated, Centralized Blood
Service: Sanquin
W Martin Smid
Director Academic Institute IDTM
Mananging Director SCO
07 July 2015 | 1
OUTLINE OF PRESENTATION
• Introduction: Sanquin
• History
• Consolidation and Centralization
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•
•
•
The Merger
Consolidation
Uniformity
Cost Efficiency
• Blood Bank
• Blood Supply Management
• Reduction in Demand
• International Cooperation
• Conclusions
Sanquin the Dutch Blood Supply
• Sanquin is responsible for supplying blood in The Netherlands
on a not-for-profit basis
• Sanquin is the only organization licenced in the Netherlands
• The hundreds of thousands of donors who give blood
on a voluntary basis are the heart of the organization
• Core activity: producing and supplying blood and plasma products
for treating patients – safely and efficiently
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Sanquin Organization
Executive Board
Corporate staff
Blood Bank
Plasma
Products
Diagnostic
Services
Research
Reagents
Pharmaceutical
Services
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Key figures 2013 (1)
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History
1901 Karl Landsteiner discovers ABO blood groups
1914 Discovery of principle of anticoagulation
1923 First civil blood transfusion service founded
in London
1925 First donor service founded in Rotterdam
1900 - 1925
1926 - 1950
1959 CLB moves to Plesmanlaan
1960 First new-style blood bank founded in Rotterdam
1962 Law on human blood accepted
1964 Cryoprecipitate is discovered
1972 Freeze-dried factor VIII
1973 Plan for 25 blood banks
1975 Newly built fractionation plant in Amsterdam
1951 - 1975
1930 Dutch Red Cross blood transfusion service
founded
1937 Rhesus blood group system discovered
1943 Anticoagulation methods discovered
1940 Fractionation set up in Amsterdam and
Rotterdam
1944 Freeze-dried plasma
1949 Cohn fractionation
1946 CLB founded, mobile blood collection campaigns
1976 - present
1988 Law on blood transfusion
1992 New plasma factory CLB
1998 Collaboration with CAF
1998 22 blood banks and CLB
merge to form Sanquin
2000 Law on blood supply
2006 9 blood banks reduced to 4
2010 One Blood Bank
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Cause for merger and centralization
• Investigation by the Ombudsman initiated by complaints of hemophilia
patients about government action against HIV infection(1980-1985)
• 1995 Report of Ombudsman published
• Conclusion: no wrong doing of Central Laboratory and 22 red cross blood banks
• Necessary actions were taken by the players
• Government oversight too complicated with 23 independent players
• Need for transparency of oversight and inspection
• Government would benefit from centralization
Influencing situational factors
• Positive:
• The idea of standard quality of products and the need for quality assurance
• The acting Minister of health had a back ground in blood bank and central
laboratory
• Centralization was a clear trend within government
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Negative:
Central laboratory and blood banks were different worlds
Much fear for effects on donor relations
Consequences for co-workers
The start
• Merger of central laboratory and 22 independent blood banks
• Process directed by the Ministry of Health
• After two years of preparation Sanquin was founded on January 1st 1998
• New name introduced at that time.
• Former entities all entered lock stock and barrel in the new structure
1997
Signing
at MoH
Consolidation in steps
• 1998 start of Sanquin
• 22 Blood Banks transformed to 9 Blood Bank Divisions
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Process in regions had already started from 1996
Gradually and bottom up
Continuity and safety were main
New building for regional headquarters
• Central Laboratory transformed in three divisions
• Plasma fractionation, Diagnostics and Research
• Plasma division had started international collaboration with CAF
Next step to more uniformity
• 2006 a second Consolidation Step
• From 9 to 4 blood bank divisions
• Reasoning: more uniform products and processes and more economic
• Improvement based on best practices
• Process approach bottom up with working parties of experts
• Discussion centered around 2,3 or 4 divisions
• Limited financial advantage and 4 considered more reliable than 2
• Advantages of centralized screening laboratory were obvious and NSS
(National Screening laboratory Sanquin) is implemented
• Delivery of test tubes in the evening and testing at night
• Further cost efficiency through central purchasing
And then the need for more efficiency
• Consolidation to a centralized national blood bank in 2010
• Reasoning: cost efficiency and guarantee of quality with uniform products
and processes combined with central purchasing
• Four division become one centralized blood supply
• Process approach had changed to top down
• Organizational model changes from division model to centralized
organization with four Units
• Donor affairs, Processing, Transfusion Medicine, Quality Assurance
Executive Board/Director
Donor Affairs
IC-BB
Release management
Secretariat
Consulting Services
Production
IC-BB=Information Centre Blood Bank, P/I/C = Processing/Issue/Customer service,
DTM= Department of Transfusion Medicine, QA/RA=quality assurance, regulatory affairs
DTM/
Medical affairs
QA
and RA
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A Centralized Consolidated Blood Supply
• Donor Management and Collection
• 3 Regions for Mobile Collections
• Centralized Donor Management
• Processing
• 2 Locations
• 11 distribution centers: based on mathematic model for delivery of Hospitals
• Transfusion Medicine
• 4 regions near the hospitals with “bridge” specialists
• Quality Assurance and Control
• At the Two Processing Locations
• National Screening Laboratory (Sanquin Diagnostics)
Blood Supply Management
• Developing from 2010 (EBA, Council of Europe, ISBT, Australia)
• In essence provide sufficient and safe blood for patients in need in a cost
efficient way with minimal discard
• Combination of Donor management and production logistics
• DOnor MANagement IN Europe (DOMAINE)
• Mathematical model for stock management
• Challenge: demand for blood in the Netherlands is decreasing the
collection amounts to 27/1000 whole blood donations last year
The logistics of blood supply in The Netherlands
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Delivery of blood at all times
• According to the Dutch Transfusion Law
• Sanquin provides the blood as needed by Hospitals
• Includes the blood groups as requested
• Distribution is supported by Unit Transfusion Medicine
• Includes delivery by Sanquin of the blood product to the hospitals
• For emergency “1 hour criterion”
• All blood types
Blood Supply Management
RBC use
448,488
Platelets (donor units)
264,906
Fresh frozen plasma
67,071
Kilograms plasma
total (incl. apheresis)
supplied to
Plasma P division
308,895
Education and advice
• Sanquin provides education and training
• Sanquin participates in education programs of higher vocational colleges
and universities, including the training courses for medical specialists and
courses for blood transfusion physicians and specialists
• Sanquin provides specialized courses and refresher courses for
professionals in the medical world
• Consultancy is focused on knowledge transfer to low and medium income
countries
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International cooperation
• For a national blood supply organization peers are in an international field
•
Especially in Europe: same EU guideline is applicable
• International Cooperation:
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•
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The Sanquin Blood Bank of Frozen Blood supplies units of rare blood types
Surpluses and ad hoc collection for international (emergency) aid and UN
International reference function
• Following the consolidation in plasma fractionation
• In the field of International Blood Safety
• Partnerships with organizations abroad and the Dutch Red Cross:
Sanquin and International Blood Safety
• Sanquin Consulting Services
• Mission Statement
• Activities since 2010:
• Projects: Uganda and Zambia (PEPfAR no cost extension), Pakistan (GIZ) Turkey
(EU funded), Curacao, Sri Lanka (Government of SL), Suriname (UTSN Twinning),
Montenegro (WHO: EU funded)
• Internships
• International cooperation:
• In projects and otherwise: e.g. WHO, AfSBT, ISBT, AABB, Red Cross Blood Bank
Curacao, UTSN, GFA, Simed, IBSF, IDTM
Sanquin and IDTM
• Academic Institute for International Development of Transfusion Medicine
• Collaboration of Sanquin and University of Groningen and University Medical
Center Groningen
• Offers a Master in Management of Transfusion Medicine at the Graduate School
of Medical Sciences of the University Medical Centre Groningen
• Sanquin Provides the Internship during the second year
• Two year master program: 1st year distant e-learning, 2nd year internship
Haemovigilance in the Netherlands
• Named TRIP: Transfusion Reactions In Patients
• Collaboration of most stakeholders in the blood transfusion chain
• Administration and additional investigation by questions asked
• Reporting by hospitals is Web based with additional possibility to forward
also to the Inspectorate of Health and/or Sanquin
• Yearly report: www.trip.nl
Plasma Products division
• The Sanquin Plasma Products division produces 11 types of medicines
from plasma; coagulation factors, protease inhibitors, immune globulins
and albumin
• The Sanquin Plasma Products division co-operates closely with sister
organizations abroad, like the Belgian CAF-DCF, the Finnish Red Cross
Blood Transfusion Service and the French LFB
• Collaboration based on economies of scale and efficiency
• Production facilities in Amsterdam and Brussels
• Very recently separated financially to minimize the risks for the public
blood bank part (to contain possible financial risks for Blood Bank)
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In conclusion
• Sanquin is the Dutch Blood Supply on a non profit basis
• Stepwise consolidation and centralization during two decades resulted in a
National blood supply; combining quality, research, efficiency.
• Challenges are the the ever decreasing demand of RBC and financial
restrictions and risks
• International cooperation with peers in order to be able to continue to
improve and to share
• Knowledge transfer in cooperation with low and medium countries
Name and logo
• Sanquin is a reference to the French (le sang) and Latin (sanguis) words
for blood
• The logo is based on a centuries-old legend
• The mother pelican feeds her hungry young with her own blood
to save their lives
• This is why it has become a symbol of altruism and compassion
• Blood from donors saves the lives of many patients
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Ambitions
Sanquin possesses a rich history and has deep roots in Dutch society.
Based on this strong foundation, Sanquin wants to:
• Expand its international activities
• Continue to focus on quality and innovation
• Conduct research and share knowledge to advance transfusion medicine
nationally and internationally
• Continue to focus on the donor
Without donors, the blood supply service in The Netherlands
would not exist. Sanquin is fully aware of this, every day.
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