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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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Chetan (M.S.) MakamCopyright© 2008 Haemonetics
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
Chetan (M.S.) MakamCopyright© 2008 Haemonetics
PerspectivesPerspectives
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Chetan (M.S.) MakamCopyright© 2008 Haemonetics
About Haemonetics (HAE)Devices, Software & Services
DeliveringClinical Benefits
Economic AdvantagesRegulatory Compliance
Donor & PatientSatisfaction
TEG® 5000
Chetan (M.S.) MakamCopyright© 2008 Haemonetics
A Growing Portfolio Of Solutions That Help Our Customers Achieve Their Mission
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Chetan (M.S.) MakamCopyright© 2008 Haemonetics
The Blood Supply Chain
Chetan (M.S.) MakamCopyright© 2008 Haemonetics
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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Chetan (M.S.) MakamCopyright© 2008 Haemonetics
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
Chetan (M.S.) MakamCopyright© 2008 Haemonetics
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
Chetan (M.S.) MakamCopyright© 2008 Haemonetics
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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Chetan (M.S.) MakamCopyright© 2008 Haemonetics
• 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
Chetan (M.S.) MakamCopyright© 2008 Haemonetics
Blood Collection
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Chetan (M.S.) MakamCopyright© 2008 Haemonetics
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.
Chetan (M.S.) MakamCopyright© 2008 Haemonetics
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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Chetan (M.S.) MakamCopyright© 2008 Haemonetics
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
Chetan (M.S.) MakamCopyright© 2008 Haemonetics
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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Chetan (M.S.) MakamCopyright© 2008 Haemonetics
Applying Process Excellence
• What is Process Excellence ?
• Videos
Chetan (M.S.) MakamCopyright© 2008 Haemonetics
Future
PastPresent
All Problems Have A Past, Present And Future!
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Chetan (M.S.) MakamCopyright© 2008 Haemonetics
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.
Chetan (M.S.) MakamCopyright© 2008 Haemonetics
How to Solve the Supply Chain Challenges ?
• Which club do I choose to hit the golf ball ?
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Chetan (M.S.) MakamCopyright© 2008 Haemonetics
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
Chetan (M.S.) MakamCopyright© 2008 Haemonetics
Lets Talk Lean & Six Sigma Over Coffee
Lean
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Chetan (M.S.) MakamCopyright© 2008 Haemonetics
Six Sigma
Lets Talk Lean & Six Sigma Over Coffee
Chetan (M.S.) MakamCopyright© 2008 Haemonetics
How can I make a great cup of coffee fast ?
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Chetan (M.S.) MakamCopyright© 2008 Haemonetics
Blood Center Processes
Chetan (M.S.) MakamCopyright© 2008 Haemonetics
• 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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Chetan (M.S.) MakamCopyright© 2008 Haemonetics
Blood Center Processes
• Donor Recruitment to Customer• Lets start with a 1000 phone calls…
Chetan (M.S.) MakamCopyright© 2008 Haemonetics
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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Chetan (M.S.) MakamCopyright© 2008 Haemonetics
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
Chetan (M.S.) MakamCopyright© 2008 Haemonetics
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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Chetan (M.S.) MakamCopyright© 2008 Haemonetics
Lean Example : Component Lab Flow
Chetan (M.S.) MakamCopyright© 2008 Haemonetics
Lean Example : 5S In A Blood Bank
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Chetan (M.S.) MakamCopyright© 2008 Haemonetics
Donor Floor : Flow
Chetan (M.S.) MakamCopyright© 2008 Haemonetics
Donor Floor : 1-Piece Flow
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Chetan (M.S.) MakamCopyright© 2008 Haemonetics
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
Chetan (M.S.) MakamCopyright© 2008 Haemonetics
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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Chetan (M.S.) MakamCopyright© 2008 Haemonetics
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
Chetan (M.S.) MakamCopyright© 2008 Haemonetics
PerspectivesPerspectives : Again
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Chetan (M.S.) MakamCopyright© 2008 Haemonetics
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
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