Substitution or Emergency Order? Averting O-Negative Blood Shortages

Abstract

Blood type substitution is an effective policy for improving the blood supply chain resilience in responding to shortages at hospitals. However, while compatibility of certain blood types provides an opportunity to better manage volatility in supply (donation) and demand (transfusion), in practice, it remains challenging to decide whether to use a compatible blood unit from the on-hand inventory (substitution) or to place an urgent or emergency order. Available evidence indicates that, in Australia, current practices for deciding on blood type substitution over emergency orders result in a significant imbalance in supply and demand for the most widely compatible units: O-negative blood units..