The following Strategic Initiatives of MESA International ... · • Improve Customer Service...

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www.mesa.org2008 North American Plant-to-Enterprise ConferenceSeptember 21-23, Orlando, FL Copyright© 2008 Haemonetics

Chetan (M.S.) MakamDirector

Office of Business Process Excellence

Applying Process Excellence :Challenges In The Blood Supply Chain

Chetan (M.S.) MakamCopyright© 2008 Haemonetics

The following Strategic Initiatives of MESA International are associated with

this presentation:

Lean ManufacturingQuality & Regulatory Compliance

Product Lifecycle Management (PLM)Real-Time Enterprise

Asset Performance Management (APM)

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What I Am Going To Talk About

• About Haemonetics• The Blood Supply Chain• Challenges Facing the Industry • Challenges In Addressing the Supply Chain• Blood Basics and Facts• Blood Bank Processes• Applying Process Excellence• A Question and A Request


PerspectivesPerspectives

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About Haemonetics (HAE)Devices, Software & Services

DeliveringClinical Benefits

Economic AdvantagesRegulatory Compliance

Donor & PatientSatisfaction

TEG® 5000


A Growing Portfolio Of Solutions That Help Our Customers Achieve Their Mission

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The Blood Supply Chain


Hospitals and Blood Banks Face Many Blood Related Challenges

• Cancelled surgeries due to unavailable blood• Shrinking donor population for blood donation

– Deferrals– Competing civic opportunities

• Fragile blood supply chain– Inefficiencies– Manual processes

• Clinical complications and adverse reactions from blood transfusions

• Rising costs of blood transfusion

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Customer Needs Are Fundamentally The Same In All Regions Worldwide

• Hospital administrators and care givers– Better patient care and lower costs

• Blood bankers– Support regulatory compliance– Improve donor recruitment and retention– Economically sound


Challenges In Addressing The Blood Supply Chain

• Highly regulated industry

• FDA regulates blood; similar to drugs and living tissue

• All devices and software have to have a 510(k) approval

• Software is a medical device

• Centers have to approve and validate devices and

software- center by center to stringent FDA rules

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Copyright© 2008 Haemonetics

Blood Banking Blood Banking Basics & FactsBasics & Facts

Painting The Picture To Understand Painting The Picture To Understand The Environment In Which Blood Banks OperateThe Environment In Which Blood Banks Operate


Blood : Needs

• 1 in 5 people entering a hospital need blood.

• > 4.5 million patients need blood transfusions each year in the U.S. and Canada.

• 43,000 pints: amount of donated blood used each day in the U.S. and Canada.

• Every 2 seconds, Someone needs blood

• 3 gallons of blood is used every minute in the United States

Source : America’s Blood Centers Website, 2005 HHS Study

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• The blood center’s ‘raw material’ is highly variable & unreliable

• Only 38 percent of the U.S. population is eligible to donate blood – however ~5% actually do*.

• The average donor donates less than 2 times each year.

• The reward is a warm, fuzzy feeling of having done something selfless – no incentives can be offered

• Since donation is voluntary, the donor’s schedule usually takes precedence – resulting in missed appointments, late arrivals

• Population shifts – aging, busier, less community focused – has greatly affected the donor population.

• Restrictions : Travel, piercings, tattoo’s & others

Donors & Trends

*Source : TRANSFUSION July 2008


Blood Collection

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Blood Collection (cont’d)

• The majority of blood (around 60-70% nationally) is collected at mobile blood drives.

– Often booked 3-6 months to a year in advance

• Mobile drives may be associated with a business, religious organization, civic organization, a school, or a community.

• Blood is also collected in fixed sites owned or leased by the blood center.


Blood Groups & Deferrals

• Blood Groups– Varies by population

• Deferrals– WB donor deferred for 8 weeks– Platelet/plasma donor deferred

for 48 hours– RBCP donor deferred for 8

weeks– 2RBC donor deferred for 16

weeks

Challenge : Right product, Right time, Right donor

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Blood Testing and Storage

• Number of tests done on each

unit of donated blood

• Days most donated red blood

cells can be stored.

• Days most donated platelets

can be stored.

• Days frozen plasma can be

stored.

13 tests

11 for infectious diseases

42 days

5 days

1 year


What Makes Blood Centers Unique?

• Non-profit organizations >> Strong sense of mission

• Subject to GMP by FDA

• Dependency on the goodwill of community.

• “Raw material” (Donor) is persuaded not controlled

• Blood product available whenever its needed

– Excess is collected, even when waste is expected.

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Applying Process Excellence

• What is Process Excellence ?

• Videos


Future

PastPresent

All Problems Have A Past, Present And Future!

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Problem Solving• What are some of the

approaches to problem solving?

– If we ignore it long enough, it’ll go away.

– Just wait, something worse will come up.

– Problem? Who said that there’s a problem?

– Fire everyone! We’ll just have to start over.

– Just throw it away…no one will ever know.


How to Solve the Supply Chain Challenges ?

• Which club do I choose to hit the golf ball ?

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What Are The Strategic Goals ?

Strategic Objectives• Reduce Costs• Increase Collections• Improve Customer Service

Purchasing Recruitment

Inventory Mgmt Collections

Logistics Manufacturing

Marketing Quality

HospitalServices

“Eighty five percent of the reasons for failure to meet customer expectations are related to deficiencies in systems and process…rather than the employee”

The role of management is to change the process rather than badgering individuals to do better - Deming


Lets Talk Lean & Six Sigma Over Coffee

Lean

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Six Sigma

Lets Talk Lean & Six Sigma Over Coffee


How can I make a great cup of coffee fast ?

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Blood Center Processes


• Definitions I like to Use

– Blue Collar Process• Space, Product flow, People flow

– White Collar Process• Information flow, Paper flow

Types of Processes

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Blood Center Processes

• Donor Recruitment to Customer• Lets start with a 1000 phone calls…


Process Improvement & Numbers

• The degree to which you can express something in numbers, is the degree to which you really understand it

– Lord Kelvin

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Seven Deadly Wastes In Blood Banks

• Transportation– Multiple runs to hospitals, poorly planned mobiles

• Inventory– Excess Stock on Hand

• Movement– Donor Flow, Excess Worker Motion

• Waiting– Donor wait time, Collection-Manufacturing match

• Overproduction – Collecting the wrong product, too many donors

• Over Processing– Documentation, Checks and Re-Checks

• Defects– Incomplete Health History, Donor Deferrals


Problems & Typical Areas For Improvement Using Lean

• Causes ….– Poor Floor Layout

– Long Set-Up times

– Lack of Correct Skills

– Inconsistent Performance Measures

– Ineffective Scheduling

• Lean Projects …– Free up floor space

– One piece processing

– Standardize work

– Develop staffing plans and

improve efficiency

– Improve workflow

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Lean Example : Component Lab Flow


Lean Example : 5S In A Blood Bank

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Donor Floor : Flow


Donor Floor : 1-Piece Flow

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If more defects are created, then more defects are passed on to the customer

Can you inspect in quality?

Six Sigma: Striving For Perfection

Quality : Engineered In NOT Inspected Out


Results Achieved w/ Customers

• Product Availability (~$ 2.10 MM)

• Manufacturing (~$2.60 MM)

• Recruitment, Conversion & Retention (~$0.82 MM)

• Mobile Efficiency, Logistics &Transportation (~$1.10 MM)

• Laboratory– Reduced TAT (~ 3 hrs) and increased capacity ( 22%) and

improved space utilization (23%)

• Regulatory/ Problem Management ( $$$???)

Not having to discard precious units of blood components ---PRICELESS

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The Blood Supply Chain

Right blood product, at the right time, to the right patient - who does

DONOR

SUPPLY

BLOOD BANKS

Preventing a blood transfusion to the patient - who doesn’t need one

PATIENT

DEMAND

HOSPITALS

Blood Collection

Processing& Testing

Inventory & Distribution

Hospital BB Inventory

Transfusion Preparation

Recruitment& Interview Point of Care

Pre Intra Post


PerspectivesPerspectives : Again

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A Question and A Request

• How many of you have donated in the past year ?

• #1 reason people do not donate blood is that they were not asked

Consider yourself asked!PLEASE DONATE & MAKE IT A DOUBLE

The following Strategic Initiatives of MESA International ... · • Improve Customer Service...

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