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A simulation-based approach for improving the clinical blood sample supply chain

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Abstract

We consider a three-echelon blood sample supply chain comprising the following elements: (i) clinics, where blood samples are taken from patients, (ii) centrifugation centers, where collected blood samples are separated into their different components, and (iii) a centralized testing laboratory, where the samples are analyzed. We focus on the scheduling of vehicles that transport blood samples from clinics to centrifugation centers—a special case of the vehicle routing problem (VRP). Our study presents a novel simulation-based approach to the VRP, designed and implemented in MATLAB, and tailored to the unique constraints of the three-echelon blood sample collection chain. We apply this approach to data from a large Health Maintenance Organization to determine the optimal vehicle fleet size for blood sample transport, while ensuring that the quality of the healthcare service is not compromised. Results suggest that our simulation model can be generalized to serve as a useful and straightforward decision support tool for optimizing resource utilization and service quality in healthcare systems.

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Notes

  1. As shown in Table 1, there are 183 clinics in the Tel Aviv and Dan-Peth Tikva districts. However, the 80 clinics under study are the only ones falling in these five clusters and are serviced exclusively by their own set of vehicles.

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Acknowledgments

This work was supported by grant 135/2012 from the Israel National Institute for Health Policy Research.

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Authors and Affiliations

  1. Department of Management, Bar-Ilan University, 52900, Ramat-Gan, Israel

    Amir Elalouf & Dmitry Tsadikovich

  2. Clalit Health Services, Tel-Aviv, Israel

    Sharon Hovav

Authors
  1. Amir Elalouf
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  2. Dmitry Tsadikovich
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  3. Sharon Hovav
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Corresponding author

Correspondence to Dmitry Tsadikovich.

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Appendices

Appendix 1 - Location of the centrifugation process within blood sample chains

Table 11 Comparison of different structures of the blood sample collection chain
Full size table

Appendix 2 - Differences between Tel Aviv and Dan-Petah Tikva districts

Table 12 Differences between Tel Aviv and Dan-Petah Tikva districts on two performance measures as a function of fleet size
Full size table

Appendix Table 12 shows that the performance measures in the Dan-Petah Tikva district are weaker than those in the Tel Aviv district. In particular, the average waiting times of samples in the clinics (AS) are higher, while the number of samples delivered to the centrifugation center on time (SD) is lower.

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Elalouf, A., Tsadikovich, D. & Hovav, S. A simulation-based approach for improving the clinical blood sample supply chain. Health Care Manag Sci 24, 216–233 (2021). https://doi.org/10.1007/s10729-020-09534-0

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