How continuous improvement saves lives

Known for its biological manufacturing, the Australian Red Cross Blood Service has expanded beyond blood, and has adopted a well-known strategy to constantly improve their processes. Manufacturers’ Monthly finds out.

Every week across Australia around 29,000 blood, plasma, and platelet donations are required to meet the needs of patients. Organs and tissues need to be matched for transplants, and premature babies need pasteurised breast milk to help them when they’re at their most vulnerable. An operation like this requires meticulous coordination of volunteer donors, blood collection, testing and manufacturing, and logistics, all to meet the ever- changing needs of Australian patients.

This is where the Australian Red Cross Blood Service comes in. The journey of blood is complex; with nearly 90 donor centres across the country, over half a million volunteer donors and almost 4,000 employees. Managing this supply chain involves a steady focus on ensuring the right product is available at the right time and that it’s safe for those receiving it, as Mitra Burns, national continuous improvement manager at the Blood Service explains.

“We’re very much supply-and- demand focused,” said Burns.

“We identify what products we need based on demand from hospitals, and what we already have on hand. Once this is established, our teams focused on donor recruitment ensure we have the right donors coming in at the right times.

“In some cases, patients may need blood that’s specifically matched beyond the eight main blood groups, and this is where our medical and scientific experts coordinate to make sure we can meet the increasingly unique needs of all Australian patients.”

Once at a donor centre, donors will be asked to complete an eligibility questionnaire and complete a donation assessment to ensure giving blood is safe, not only for them, but also for the patient receiving their blood.

“The process of screening donors is essential in ensuring the safety and quality of the products we supply,” said Burns.

Before blood or a blood product can be given to a patient, it must first be processed at one of four processing centres located in Brisbane, Sydney, Melbourne, and Perth. Here the donations are separated into their different components, tested, and blood typed, before being released and sent to hospitals across the country. While complex, this cohesive system is based on continual changes in demand for specialised and sometimes precise products. When demand in the health sector shifts, the supply process must also adapt to accommodate.

“For the first time this year, we are now collecting more plasma donations than blood, which brings with it more change; change to our capacity and to our processes,” said Burns.

Knowing that the shift from whole blood to plasma was about to occur, in 2013 the Blood Service implemented a Continuous Improvement (CI) strategy to ensure the service remained at its peak.

“We, like most organisations, could see we had room for improvement. Our leadership team saw these opportunities and knew CI was the right strategy to help us make the top quartile in international benchmarking,” said Burns.

While the Blood Service is unique in the products it manufactures, it is similar to many other manufacturing businesses requiring quality and reliability in their process through well designed systems. With this in mind, Burns expressed a sentiment common to other production managers.

“Despite planning meticulously, we know things don’t always work perfectly. Part of our system is ensuring if something doesn’t go to plan, not only is it captured and resolved, but it’s always reviewed to ensure it’s not an ongoing problem.

“There is always room for improvement. Documentation and review is a key part of this. If you don’t have this, if you don’t know where your areas for improvement are, then you cannot improve.”

This review process is an essential part of CI, with the Blood Service evaluating its progress, in addition to looking further afield for other developments.

“As part of our review we wanted to check the current status of where Lean thinking was. We looked at what we were doing well, what our challenges were, but we also wanted to know what other similar organisations were doing, so we looked to the blood services in Canada and the UK to see what they were doing well, and what their challenges were too.”

As Burns highlighted, Lean manufacturing is a global network of companies and organisations and asking how others measured themselves could lead to improvements in the Blood Service.

After benchmarking internationally, the Blood Service’s next step was focussed on improving the individuals who worked within the organisation.

“Lean for us now is about empowering our people to continuously improve in their everyday roles, rather than waiting for a Lean practitioner to come and make the changes for them. A key part of this shift was the support of our leadership team in recognising our own people are the right people to achieve great results.”

Here, rather than requiring major disruption, what the CI Team highlighted was the inherent qualities of the existing workforce. This was introduced to the organisation through in-house training and workshops, a method that Burns described as, “I do, we do, you do”.

“I do, is that I’ll train you, so it’s a combination of classroom training and an example to work through. We do, is that you and I partner together, and we do a number of projects to a stage where you’re competent and you can do it on your own. And you do, is the coaching and mentoring stage.”

To date, the organisation is already seeing results, and individuals within the organisation are taking it upon themselves to improve the processes of blood collection and manufacturing.

“A key part of rolling this out across the Blood Service has been helping people realise it applies to all areas. It’s not limited to manufacturing; these opportunities for CI are everywhere. They’re in our call centre, in our donor centres, in our admin teams, in our labs and of course in our manufacturing areas,” said Burns.

“We’re helping our people change the way they look at processes and the work they do. We’re helping them think differently when it comes to finding solutions, and we’re developing and empowering them to keep making these continuous improvements. It’s a never-ending journey.”