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National Centralized Blood System By: Ahmad Gharehbaghian MTD, PhD (Faculty member of Iranian Blood Transfusion Organization) First Meeting of Blood Services.

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Presentation on theme: "National Centralized Blood System By: Ahmad Gharehbaghian MTD, PhD (Faculty member of Iranian Blood Transfusion Organization) First Meeting of Blood Services."— Presentation transcript:

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, 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 What is big challenge in blood adequacy and safety? 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 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 1. Advocacy and resource mobilization 2. Collaboration with state, regional centers and NGOs 3. Development of technical guidelines and SOPs 4. Institution of a monitoring and evaluation mechanism for quality management Iranian blood transfusion organization-Research centre

9 Important roles (continued) 5. Identification of referral centers 6. Promotion of research and development 7. Development of a plan for disaster management 8. Establishment of fractionation policies Iranian blood transfusion organization-Research centre

10 Advantages of Centralized Blood Systems 1. Cost reductions - High-volume testing - High-volume purchasing leading to cost savings - Centralized delivery of transfusion services leading to financial savings 2. Appropriate use of transfusion experts and senior staff 3. Improved quality by nation-wide standardization 4. Improved resource management 5. Increased efficiency 6. Development of a core of transfusion medicine specialists Iranian blood transfusion organization-Research centre

11 Advantages (continued) 7. Encouragement of the exchange, standardization, and optimization of transfusion practice 8. Establishment of a centralized database of patient transfusion history and specialized blood component requirements 9. Centralized nation-wide database of patient transfusion history 10. Establishment of transfusion medicine specialists as a community resource 11. Staff efficiency 12. Implementation of appropriate strategy in disasters Iranian blood transfusion organization-Research centre

12 13. 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 14. Centralized management of blood resources across the whole nation 15. Report of adverse reactions and errors 16. Use of automate and computerized system 17. Active involvement of blood centers in clinics and hospitals 18. Exact centralized oversight (error management) 19. Encouragement of end-users to cooperate with blood centers 20. Reduction of inappropriate blood prescriptions & blood orders review Iranian blood transfusion organization-Research centre Advantages (continued)

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

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

18 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

19 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 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

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

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

22 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

23 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

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

25 Testing and distribution of blood components Why? IBTO: Regional/Decentralized?! 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

26 Thanks, wish you all a happy stay in Iran

27 Iranian blood transfusion organization-Research centre

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29 IBTO Research Center 2003 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. Iranian blood transfusion organization-Research centre

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


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