More than 36,000 blood donations are needed daily in the U.S., accounting for nearly 21 million annual blood component transfusions. The demand for blood transfusions is ample due to high prevalence of chronic diseases and ageing of the population. The margin between blood need and transfusable blood product availability has been critically tight, and warnings of blood shortages have received extensive media coverage. American Red Cross and Georgia Tech competed for the 2017 Franz Edelman Award.
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Due to the limited supply and perishable nature of blood products, effective management of blood collection is critical for high quality healthcare delivery. After collection, whole blood can be processed into different blood components including red blood cells, platelets, plasma, and cryoprecipitate. Among these products, the collection of cryoprecipitate (or “cryo”) is particularly challenging. To be processed into cryo units, the collected whole blood has to be shipped to the production facility and be processed within eight hours after collection. Almost all other blood products can be processed within 24 hours of collection. This tight time constraint between collection and production can only be satisfied with extra courier services, which makes the collection of cryo units more costly than other products.
Cryo plays a critical role in clotting and controlling hemorrhaging and is often used in the treatment of massive trauma and major diseases, including metastasized cancers, cardiac diseases, hepatic failures, and organ transplants. From 2000 to 2010, the use of fresh-frozen plasma, the raw material for cryo production, increased tenfold and grew to more than 2.4 million units used annually in the United States.
In this study, we describe and analyze a regional level cryo collection problem faced by the American Red Cross Douglasville Blood Processing Center (Georgia), one of the Red Cross’s largest supplier of blood products serving the Red Cross Southern Region (Atlanta-area) hospitals. In particular, this project focused on determining when and from which mobile collection sites to collect blood for cryo production and how to schedule the courier services such that the collection targets are met and the total collection costs are minimized. A regional level cryo collection problem imposes several challenges: i) if the blood collected is to be processed into cryo units, it has to be processed within eight hours after collection; ii) the collection quantities are uncertain due to donor no-shows, random walk-ins, and random yields in production; and iii) collection schedules need to be made in advance and may need to be dynamically adjusted depending on the realizations of uncertainties.
To formally analyze the problem and optimize the collection schedules, we first formulated a large-scale stochastic dynamic program (DP), which considers all collection sites and dynamically determines the sites for cryo collection over the week. However, given the size of the problem, the corresponding DP is computationally intractable. To solve the problem, we structurally analyzed this model, proved several structural properties, and developed a near optimal solution algorithm. To facilitate implementation, we also developed a decision support tool (DST) to systematize the selection of the collection sites, which is now used in practice in the Red Cross Southern Region.
The implementation of the DST in the Red Cross Southern Region led to an increase in the number of whole blood units satisfying the eight-hour collection to process constraint for cryo production (capacity expansion). In particular, during the fourth quarter of 2016, the Red Cross was able to process about 1,000 more units of cryo per month (an increase of 20 percent) at a slightly lower collection cost (cost avoidance), resulting in an approximately 40 percent reduction in the per unit collection cost for cryo.
Finally, these findings have been recently presented to other Red Cross Biomedical Services executives at a national Red Cross conference, and plans are in place to extend the implementation of the DST to the 11 other Red Cross cryo processing facilities in the future.