Canadian Blood Services Inventory Management

Canadian Blood Services Inventory Management

Robert Romans

GHEST, September 28, 2013

Inventory Management - Objectives

Supply Chain Planning and Process Demand Forecasting Tools of the Trade Future Opportunities

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Supply Chain Flow … “forecasts” and “tracking” are ongoing

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HProduction PlanningProduction PlanningPlanning/Budgeting

Event/ StaffPlanning



DonorRecruitment

DonorRecruitment

DonorRecruitment

CollectionsCollectionsCollections

Donor TestingDonor TestingDonor TestingComponent ProductionComponent ProductionComponent Production

Label & ReleaseLabel & ReleaseLabel & Release

Inventory& IssuingInventory& IssuingInventory& Issuing

Demand Forecasting

Demand

Demand ForecastingDemand Forecasting

Demand

Supp

lySu

pply

PerformanceAnalysis

PerformanceAnalysis

PerformanceAnalysis

HProduction PlanningProduction Planning

HProduction PlanningProduction PlanningPlanning/Budgeting


Planning/Budgeting





DonorRecruitment

DonorRecruitment


DonorRecruitment

DonorRecruitment

DonorRecruitment

DonorRecruitment

CollectionsCollectionsCollectionsCollectionsCollectionsCollections

Donor TestingDonor TestingDonor TestingDonor TestingDonor TestingDonor TestingComponent ProductionComponent ProductionComponent ProductionComponent ProductionComponent ProductionComponent Production

Label & ReleaseLabel & ReleaseLabel & ReleaseLabel & ReleaseLabel & Release

Inventory& Issuing

Label & Release

Inventory& IssuingInventory& IssuingInventory& IssuingInventory& IssuingInventory& Issuing

Demand Forecasting

Demand


Demand

Supp

lySu

pply

PerformanceAnalysis

Demand Forecasting

Demand


Demand

Supp

lySu

pply

PerformanceAnalysis

PerformanceAnalysis

PerformanceAnalysis

To maximize service delivery and stakeholder value, customer demand needs to be at the forefront of everything we do

Appointments ABO Rh Levels Hospital Demand

Donors

Collections

Inventory

Appointment Preparedness

Discards

Order Fill

Supply Chain Management Model

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The collection, manufacturing and delivery of blood products is a complex business, supported by a host of enablers. Demand forecasts provide the lead

time necessary to ensure that supply is available to meet demand.

Meeting hospital demand STARTS here

Hospital Demand Forecasting Process

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May

June & Nov Nov/Dec

• Feeds high level Budget sizing, Collection & Production target setting

• Utilizes two months of current year data

Preliminary Top Down Forecast

Preliminary Bottom Up Forecast

Top Down/ Bottom Up

Rationalization

“Official”Demand Forecast

Prepare & Distribute Hospital Canvass

Worksheets

HCSR’sReview

Worksheets with Hospital

Contacts

Strategic/ Executive Direction

(Overlays)

Time Series Analysis

(Historical Data Trends)

Strategic/ Executive

Rationalization

Bottom Up Forecast:

• RBC, Platelets & Plasma

• Feeds detailed Budget distribution, Collection & Production tactics

Utilizes six months current year data

Top Down Forecast:

• Product level of detail as required


• Utilizes one month of current year data



Top Down/ Bottom Up

Rationalization



Worksheets

HCSR’sReview


Contacts


(Overlays)




Rationalization



Top Down/ Bottom Up

Rationalization



Worksheets

HCSR’sReview


Contacts


(Overlays)




Rationalization

Bottom Up Forecast:

•


Preliminary Top Down Forecast:


Updated Top Down Forecast:

• Quarterly updates

May

June & Nov Nov/Dec





Top Down/ Bottom Up

Rationalization



Worksheets

HCSR’sReview


Contacts


(Overlays)




Rationalization

Bottom Up Forecast:




Top Down Forecast:






Top Down/ Bottom Up

Rationalization



Worksheets

HCSR’sReview


Contacts


(Overlays)




Rationalization



Top Down/ Bottom Up

Rationalization



Worksheets

HCSR’sReview


Contacts


(Overlays)




Rationalization

Bottom Up Forecast:

•






May

June & Nov Nov/Dec





Top Down/ Bottom Up

Rationalization



Worksheets

HCSR’sReview


Contacts


(Overlays)




Rationalization

Bottom Up Forecast:




Top Down Forecast:






Top Down/ Bottom Up

Rationalization



Worksheets

HCSR’sReview


Contacts


(Overlays)




Rationalization



Top Down/ Bottom Up

Rationalization



Worksheets

HCSR’sReview


Contacts

May

June & Nov Nov/Dec





Top Down/ Bottom Up

Rationalization



Worksheets

HCSR’sReview


Contacts


(Overlays)




Rationalization

Bottom Up Forecast:




Top Down Forecast:






Top Down/ Bottom Up

Rationalization



Worksheets

HCSR’sReview


Contacts


(Overlays)




Rationalization



Top Down/ Bottom Up

Rationalization



Worksheets

HCSR’sReview


Contacts


(Overlays)




Rationalization

Bottom Up Forecast:

•






3-4 year Outlook (Corp. Plan)

Quarterly Reviews

Annual (forecasting support) Analysis

Hospital Demand Forecasting Process … Why this Process?

• Provides Base-Line and Overlay (reforecast) functionality

• The past has generally been a good predictor of the future …

hospital demand is highly seasonal in nature

• Hospital Liaison Specialists (HLSs) meet regularly with Hospital blood bank personnel:

• to update CBS’s Hospital Profile information • to understand hospital activities, programs/practices

and changes, and • to try and get a sense on past and future Blood Product

demand AND reasons for those changes (e.g.., procedures, protocols, beds, etc.)

• ALL of the above activities are currently work in progress

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One of the challenges in forecasting Hospital Demand … knowing exactly what Blood Components are used for in each

hospital and how many patients were treated for each procedure

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Average units of blood/blood products required per patient = 4.6 units

Our Hospital Profile database currently includes Hospital programs and practice

information for ~ 480 hospitals

…

Modifications are currently underway to gather more insightful profile information

from the Hospitals by early 2014

Daily Inventory Management: Overview

Production Managers chair Daily Inventory Teleconference – monthly rotation.

Conference call held 12:30 EST

Develop a proposed plan of action to ensure all sites have adequate Red Cell, platelet, and frozen inventory

Attendees are representatives of all Production/Distribution sites

Daily inventory movement is documented and sent to all CBS sites.

Inventory Management Tools - RBCs • Daily Red Blood Cell Worksheet reflects the levels of

Red Blood Cell Concentrate measured in Days On Hand (DoH) by ABO/Rh

• A DoH is the current inventory divided by an average days historical demand. This provides a normalized measure of inventory that allows direct comparison of inventory at sites of different sizes

• Optimal Levels – 5-8 DoH (all blood groups)

Daily Red Cell Concentrate Worksheet

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Inventory Management Tools – Frozen Components

• Frozen Product Inventory Worksheet reflects the levels of Frozen Inventory measured in Weeks On Hand (WoH)

• Optimal levels – Groups O, A and B is 2-3 WoH – Group AB is 3-5 WoH.

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Frozen Product Inventory Worksheet

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Inventory as of: Frozen Product InventoryWeeks Target 2.5 4

Include Stock, WIP & Intrans

Sites FP FP DIV** AFFP CAFFP Total* Target Var WOH Status FP

FP DIV** AFFP CAFFP Total* Target Var WOH Status FP FP

DIV** AFFP CAFFP Total* Target Var WOH Status

BC AND YUKON 373 6 25 37 466 450 16 2.6 Opt 117 4 42 19 224 400 -176 1.4 Min 49 6 18 25 116 130 -14 2.2 OptCALGARY 74 1 50 - 175 170 5 2.6 Opt 102 7 87 3 286 210 76 3.4 Exs 59 - 17 - 93 60 33 3.9 ExsEDMONTON 248 - 25 - 298 230 68 3.2 Exs 92 - 113 - 318 240 78 3.3 Exs 73 - 31 - 135 60 75 5.6 ExsSASKATCHEWAN 114 - - 1 115 120 -5 2.4 Opt 98 - - 7 105 120 -15 2.2 Opt 50 - - - 50 60 -10 2.1 OptWINNIPEG 115 4 7 2 135 230 -95 1.5 Min 128 6 48 6 236 190 46 3.1 Exs 48 5 - 2 55 50 5 2.8 OptBRAMPTON 1,002 - 40 1 1,083 1,040 43 2.6 Opt 302 - 308 - 918 1,140 -222 2.0 Opt 266 - 29 - 324 400 -76 2.0 OptOTTAWA 168 3 57 19 304 240 64 3.2 Exs 78 2 33 40 186 240 -54 1.9 Min 50 - 28 5 111 90 21 3.1 ExsDARTMOUTH 54 - 113 - 280 220 60 3.2 Exs 108 - 122 - 352 270 82 3.3 Exs 14 - 42 - 98 70 28 3.5 ExsNEWFOUNDLAND 15 - 36 - 87 70 17 3.1 Exs 5 - 27 5 64 100 -36 1.6 Min 20 - 5 1 31 30 1 2.6 OptTotal 2,179 14 357 60 2,967 2,770 197 2.7 Opt 1,079 19 784 80 2,746 2,910 -165 2.4 Opt 639 11 171 33 1,025 950 75 2.7 OptTotal* counts AFFP twice

Include Stock and WIP

Sites FP FP DIV** AFFP CAFFP Total* Target Var WOH Status FP FP

DIV** AFFP CAFFP Total* Target Var WOH Status

BC AND YUKON 58 2 41 40 182 220 -38 3.3 Opt 597 18 126 121 988 1,200 -212 2.1 OptCALGARY 49 8 75 5 212 140 72 6.1 Exs 284 16 229 8 766 580 186 3.3 ExsEDMONTON 100 5 63 - 231 120 111 7.7 Exs 513 5 232 - 982 650 332 3.8 ExsSASKATCHEWAN 56 5 - 2 63 60 3 4.2 Opt 318 5 - 10 333 360 -27 2.3 OptWINNIPEG 49 6 19 3 96 80 16 4.8 Opt 340 21 74 13 522 550 -29 2.4 OptBRAMPTON 103 17 41 - 202 620 -419 1.3 ER 1,673 17 418 1 2,527 3,200 -674 2.0 OptOTTAWA 53 8 45 6 157 170 -13 3.7 Opt 349 13 163 70 758 740 18 2.6 OptDARTMOUTH 95 - 17 - 129 90 39 5.7 Exs 271 - 294 - 859 650 209 3.3 ExsNEWFOUNDLAND 25 - 17 - 59 30 29 7.9 Exs 65 - 85 6 241 230 11 2.6 OptTotal 599 51 319 56 1,344 1,530 -187 3.5 Opt 4,496 94 1,631 229 8,081 8,160 -79 2.5 Opt

20-Sep-13

PlasmaO A B

PlasmaAB Total

Daily Red Cell and Platelet Inventory Status Report

• Report is produced to provide customers with a snapshot of the local CBS inventory, as of 0300h Eastern Standard Time, Monday through Friday. The national inventory held by Canadian Blood Services may be used to offset any local shortages. Inventory Level Indicators used in the daily report are matched with those utilized in the National Plan for the Management of Shortages of Labile Blood Components.

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Daily Inventory Status Report

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CBS Site: Brampton

RED BLOOD CELL INVENTORY GREEN > 3 Days RED < 2 DaysAMBER 2-3 Days

O Pos A Pos B Pos AB Pos O Neg A Neg B Neg AB Neg Total

1,917 2,308 810 457 493 420 104 67 6,576

4.8 7.2 7.6 24.3 3.8 5.5 5.0 10.5

O Pos A Pos B Pos AB Pos O Neg A Neg B Neg AB Neg Total

7,179 7,872 3,086 1,397 1,758 1,561 346 242 23,441

6.5 9.0 12.4 24.6 4.9 7.6 7.0 13.9

PLATELET (In doses) LOCAL INVENTORY

O Pos A Pos B Pos AB Pos O Neg A Neg B Neg AB Neg Total Doses

Current Available Inventory

108 24 23 3 31 2 3 1 195

Optimal Platelet Inventory

Daily Red Cell and Platelet Inventory Status

Current Date: 2013-09-23 Time : 03:00 Hrs ESTInventory Level Indicators

Local Total Available Inventory

Days On Hand LOCAL

Total National Inventory

Days On Hand NATIONAL

90 - 120 doses

- 1 2 3 4 5 6 7 8 9

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O Pos A Pos B Pos AB Pos O Neg A Neg B Neg AB Neg

Day

s O

n H

and

Loca

l Inv

ento

ry

Green Amber Red

Production Planning Tools - Frozen Inventory Planner

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Frozen Inventory Planner Brampton

Note: As per Frozen Reports A,B,O targets are 2.5 weeks, AB targets are 4 weeks.Inventory InputStep 1 - Clear previous entries by clicking "Clear" - All data cells will be cleared of data.Step 2 - Enter Inventory DateStep 3 - Enter Data from PROGESAStep 4 - Submit Data by clicking "Submit Inventory" - Production Plan will appear in gold cells.Step 5 - Save FileStep 6 - Print (if necessary) and exit

Production InputStep 1 - Clear previous entries by clicking "Clear" - All input cells will be cleared of data.Step 2 - Enter date of production (you can input production from previous days at any time)Step 3 - Enter Data from PROGESAStep 4 - Submit Data by clicking "Submit Production"Step 5 - Click "OK" on successful input messageStep 6 - Save, Print (if necessary), and exit

Most Recent Production Plan

The Production Plan for : O A B AB2013-09-24 FP FP RP 75 9 Max2013-09-24 Cryo 2nd Stage Cryo 0 123 24 Max

1st Stage Cryo 0 0 0 Max

FP Inventory Input

O A B ABFP 1040 1140 400 620

Contingency

Inventory Date Component O+ A+ B+ AB+ O- A- B- AB-2013-09-23 ACD FFPA

yyyy-mm-dd FFPA 27 43 9 10 1 7 3 1DFP 395 263 102 35 123 51 19 9

Component O A B ABACD FFPA 1 0 0 0

FFPA 8 240 20 34DFP 808 171 206 61

Comments

Components per ABO 18 Plasma

(FP and AFFP Inventory)

Components to be Labelled (Work In Progress)

Comments

Target Doses

Submit Inventory

Clear

View FP ChartView FP History Data

View Printable Plan

View Cryo ChartView Cryo History Data

Production Planning Tools - Platelet Planner

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All units are measured in Doses.Green Header - Distribution EntriesBlue Header - Planner EntriesYellow Header - Production Entries Target # of Days of Inventory on Hand 1.9White Header and BLUE font - Calculated Discard Allowance 7%

A B = B - A

Processing Date Weekday

Opening Inventory

Test

Pending To be End Labelled by Noon (pools

Previous Day

Issues (tracking

only)

Outdates (tracking

only)

Current Day CBS Transfer Requests

Apheresis Plts

Collection

Available Opening Inventory

Hosp.

Issues (April

2012 to April 2013)

Discard Allowance

7% (Incl. QC)

Target Inventory

Contingency (Weather /

Other Factors)

Reason for Plan Variance

Target + Contingenc

y

Pooled Plts

Production Plan

Imports (tracking

only)2013-06-04 Tue 0 118 8 240 240 2402013-06-05 Wed 0 150 11 305 305 3052013-06-06 Thu 0 143 10 291 291 2912013-06-07 Fri 0 146 10 297 297 2972013-06-08 Sat 0 93 7 398 398 3982013-06-09 Sun 0 53 4 108 108 1082013-06-10 Mon 213 25 142 2 0 238 155 11 315 315 772013-06-11 Tue 79 16 84 4 0 60 155 118 8 240 240 852013-06-12 Wed 99 0 135 3 0 82 181 150 11 305 305 1242013-06-13 Thu 148 30 147 7 0 58 236 143 10 291 291 552013-06-14 Fri 129 20 154 1 0 56 205 146 10 297 297 922013-06-15 Sat 153 18 100 0 0 78 249 93 7 398 398 1492013-06-16 Sun 271 17 28 0 0 24 312 53 4 108 108 -2042013-06-17 Mon 176 16 132 31 0 0 192 155 11 315 315 1232013-06-18 Tue 39 11 106 10 10 51 91 118 8 240 240 1492013-06-19 Wed 44 15 84 0 0 79 138 150 11 305 305 1672013-06-20 Thu 106 18 66 0 0 49 173 143 10 291 291 1182013-06-21 Fri 148 92 1 10 33 171 146 10 297 297 1262013-06-22 Sat 76 0 6 55 49 93 7 398 398 3492013-06-23 Sun 36 0 10 17 7 53 4 108 108 1012013-06-24 Mon 157 78 113 24 10 0 225 155 11 315 315 90

BRAMPTON Opening Data and Previous Day Aph. Collections Target from Historical Data Plan

“Best Practices” Results Management Process

Aging Population Hospital Expansion/ Contraction

Extraneous: • Weather • Trauma • Labour Action

Analysis of

Key Drivers

Cause & Effect

Demand Forecast

Formal Results Review

Recommended Actions

Regulation

Technology

CBS Strategies/ Goals/Tactics

Comparison of Actual Results to

Target

Aging Population Hospital Expansion/ Contraction

Extraneous: • Weather • Trauma • Labour Action

Analysis of

Key Drivers

Cause & Effect

Blood Component Demand & Supply

Formal Results Review

Recommended Actions

Regulation

Technology

Strategies/ Goals/Tactics/Targets

Comparison of Actual Results to

Targets

Many factors contribute to the overall demand and supply of Blood Components. The above process represents a disciplined approach to results management that fosters a common understanding of the issues and facilitates the prompt resolution of any problems.

Future Opportunities for Inventory Management

• Establish routine order schedules for ALL hospitals

• Continue working with our hospital partners on product utilization and demand forecasting activities

• Increase opportunities to optimize inventory management by partnering with Provincial Blood Coordinating Programs and hospitals to establish real time visible inventory

Future Opportunities for Inventory Management

• Further standardization - order on line?

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Canadian Blood Services Inventory Management

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