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National Centralized Blood System

National Centralized Blood System. By: Ahmad Gharehbaghian MTD, PhD (Faculty member of Iranian Blood Transfusion Organization). First Meeting of Blood Services Directors of ECO Member States, 23-25 June 2008, Tehran-Iran. مركز تحقيقات. Basic Concept.

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National Centralized Blood System

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  1. National Centralized Blood System By: Ahmad Gharehbaghian MTD, PhD (Faculty member of Iranian Blood Transfusion Organization) First Meeting of Blood Services Directors of ECO Member States, 23-25 June 2008, Tehran-Iran مركز تحقيقات

  2. Basic Concept Have one organization provide the blood transfusion services for multiple hospitals Iranian blood transfusion organization-Research centre

  3. Basic functions of a blood transfusion centre • Management of services • Recruitment of donors • Collection, processing, storage and distribution of blood and blood components • Laboratory investigations • Participation in clinical use of blood and blood components • Teaching and training • Research and development Iranian blood transfusion organization-Research centre

  4. The Need

  5. The Need for blood supplies • Transfusion of blood and blood products: an integral and essential part of patient management • Timely and equitable access to safe blood & blood components for all patients whose lives depend on this treatment modality Iranian blood transfusion organization-Research centre

  6. Lack of national or organized blood transfusion service program Lack of safe voluntary unpaid blood donors or small size of donors pool Insufficient blood supply Unscreened blood Inappropriate use of blood products Lack of or inadequate basic QC plan Inadequate support by stockholders What is big challenge in blood adequacy and safety? Iranian blood transfusion organization-Research centre

  7. WHO report in developing countries about blood transfusion • 81 million blood units collected globally every year at a cost of at least 7.5 billion USD • 80% of the world has access to 20% of safe global blood supply • 139 countries do not have 100% voluntary donation • 6 million tests are not done on donated blood • >50% countries lack quality systems and reliable supply of reagents • Up to 50% transfusions are unnecessary Iranian blood transfusion organization-Research centre

  8. Important roles of the national blood program • Advocacy and resource mobilization • Collaboration with state, regional centers and NGOs • Development of technical guidelines and SOPs • Institution of a monitoring and evaluation mechanism for quality management Iranian blood transfusion organization-Research centre

  9. Important roles (continued) • Identification of referral centers • Promotion of research and development • Development of a plan for disaster management • Establishment of fractionation policies Iranian blood transfusion organization-Research centre

  10. Advantages of Centralized Blood Systems • Cost reductions - High-volume testing - High-volume purchasing leading to cost savings - Centralized delivery of transfusion services leading to financial savings • Appropriate use of transfusion experts and senior staff • Improved quality by nation-wide standardization • Improved resource management • Increased efficiency • Development of a core of transfusion medicine specialists Iranian blood transfusion organization-Research centre

  11. Advantages (continued) • Encouragement of the exchange, standardization, and optimization of transfusion practice • Establishment of a centralized database of patient transfusion history and specialized blood component requirements • Centralized nation-wide database of patient transfusion history • Establishment of transfusion medicine specialists as a community resource • Staff efficiency • Implementation of appropriate strategy in disasters Iranian blood transfusion organization-Research centre

  12. Advantages (continued) • Delivery of specialized transfusion medicine services to any size hospital - Coagulation factor concentrates, albumin, IVIG and related plasma derivatives - Specialized component processing or testing: leukoreduced products, CMV and other virus-safe products, irradiated components, washed and volume-reduced components • Centralized management of blood resources across the whole nation • Report of adverse reactions and errors • Use of automate and computerized system • Active involvement of blood centers in clinics and hospitals • Exact centralized oversight (error management) • Encouragement of end-users to cooperate with blood centers • Reduction of inappropriate blood prescriptions & blood orders review Iranian blood transfusion organization-Research centre

  13. Centralization of blood donor programs • Uniform policies and functions for: - Recruitment of donors - Motivation of donors - Education of donors - Maintains of donors Iranian blood transfusion organization-Research centre

  14. Disadvantage of Centralized Blood Systems: It may require a large inventory and face transport problems. Decentralized Systems: • It may be more practical • but • problems related to uniformity of services, cost-efficiency and quality management. Iranian blood transfusion organization-Research centre

  15. Which model? There is not one model that suits all countries Each country needs to study its healthcare organization, its infrastructure, resources as well as its size, geography, and the population it serves. Iranian blood transfusion organization-Research centre

  16. Experiences on Centralization • Some blood services in Latin American countriesand European,UK, France Canada, Australia New Zealand, Albania, Bhutan, Cambodia, Malaysia, the Philippines, Vietnam and Iran Iranian blood transfusion organization-Research centre

  17. Iranian Blood Transfusion Organization The only nationally accredited organization in Iran that performs blood transfusion procedures ranging from blood donor recruitment to blood distribution Iranian blood transfusion organization-Research centre

  18. Iranian Blood Transfusion Organization • IBTO is a single nonprofit organization (Iranian Blood Transfusion Organization) which is responsible for the nation’s blood supply and was established in 1974. • IBTO is a national and centralized organization with blood centers across Iran in all provinces and main cities. • There are roughly 200 fixed blood collection centres out of which 65 embark both on blood components preparation, testing, and release; the other 17 out of the total number embark just on collection and preparation with no testing. Iranian blood transfusion organization-Research centre

  19. IBTO's High Council TechnicalDepartment Department of Research Director of Renovation & Administrative Improvement Quality Assurance Department Department of Education Department of Administrative Affairs Blood Donors Education & Recruitment Department Research Center Department of Financial Affairs Occupational Safety & Health Department Department of Supply, Maintenance & Services for Medical Equipments Managing Director Department of Legal Affairs Department of Public Relation & International Affairs SecurityOffice Office of Activity Evaluation & Complaints Managing Director Office Deputy of Management Expansion & Improvement Deputy of Technical & Quality Assurance Deputy of Research & Development Regional blood transfusion centers IBTO organizational chart Iranian blood transfusion organization-Research centre

  20. Population:68,920,000, Total area:1,648,000 sq. km Iranian blood transfusion organization-Research centre

  21. Screening process ranging from proper donor selection to consultation session is precisely followed • All deferral criteria are observed • All screening tests are conducted • No blood banks in hospitals collect blood • Blood products are provided to hospitals free of charge - No charges or fees are requested for the cost of collecting, testing, processing, storing and shipping the blood. Iranian blood transfusion organization-Research centre Iranian blood transfusion organization-Research centre

  22. IBTO: National/Centralized & Regional/Decentralized?! • SOPs and guidelines, • evaluation policies, • external QC, • purchasing of screening kits, blood bags, major equipment and devices including refrigerated centrifuges, blast freezers, automated instruments or group typing tools • Blood donor recruitment policies except for some deviations cause of regional and provisional cultural and social status • Research and teaching Iranian blood transfusion organization-Research centre

  23. IBTO: National/Centralized & Regional/Decentralized?! • Need assessment meeting community blood demands • Screening tests • Preparation of blood components • Blood components dispatching • Budgeting and finance Iranian blood transfusion organization-Research centre

  24. IBTO: Regional/Decentralized?! • Testing and distribution of blood components Why? • Transport problems • Largeness of the country • Extensive scope of universities of medical sciences • Availability of specialized wards in regional hospitals e.g. transplantation or heart surgery, ... • Immediate need for blood transfusion • The vital need of special patients such as thalassemics in different provinces Iranian blood transfusion organization-Research centre

  25. Thanks, wish you all a happy stay in Iran

  26. Iranian blood transfusion organization-Research centre

  27. Iranian blood transfusion organization-Research centre

  28. IBTO-Research Centre has published more than 70 specialized educational pamphlets and 20 books about blood transfusion, blood safety, and transfusion sciences in Farsi language in last 4 years. IBTO-Research Centre embarked on publishing its specialized quarterly entitled “Khoon” (Blood) that is indexed by IMEMR and Index Copernicus. We forward copies of all our pamphlets, books, and journals to WHO and EMRO so as to be used in Farsi-speaking communities (such as Afghanistan). IBTO hopefully won the status of being a WHO Collaborating Center. IBTO Research Center 2003 Iranian blood transfusion organization-Research centre Iranian blood transfusion organization-Research centre

  29. Mixed System Hospital based centers and regional centers Iranian blood transfusion organization-Research centre

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