ORIGINAL RESEARCH Streamlining a blood center and hospital transfusion service supply chain with an informatics vendor-managed inventory solution: development, implementation, and 3-month follow-up Hamilton C. Tsang , 1,2 Adam Garcia, 3 Robert Scott, 2 David Lancaster, 3 Dianne Geary, 3 Anh-Thu Nguyen, 2 Raina Shankar, 2 Leslie Buchanan, 2 and Tho D. Pham 2,3,4 BACKGROUND: The ordering process at Stanford Health Care involved twice-daily shipments predicated upon current stock levels from the blood center to the hospital transfusion service. Manual census determination is time consuming and error prone. We aimed to enhance inventory management by developing an informatics platform to streamline the ordering process and reallocate staff productivity. STUDY DESIGN AND METHODS: The general inventory accounts for more than 50 product categories based on characteristics including component, blood type, irradiation status, and cytomegalovirus serology status. Over a 5-month calibration period, inventory levels were determined algorithmically and electronically. An in-house software program was created to determine inventory levels, optimize the electronic ordering process, and reduce labor time. A 3-month pilot period was implemented using this program. RESULTS: This system showed noninferiority while saving labor time. The average weekly transfused:stocked ratios for cryoprecipitate, plasma, and red blood cells, respectively, were 1.03, 1.21, and 1.48 before the pilot period, compared with 0.88, 1.17, and 1.40 during (p 5 0.28). There were 27 (before) and 31 (during) average STATunits ordered per week (p 5 0.86). The number of monthly wasted products due to expiration was 226 (before) and 196 (during) units, respectively (p 5 0.28). An estimated 7 hours per week of technologist time was reallocated to other tasks. CONCLUSION: An in-house electronic ordering system can enhance information fidelity, reallocate and optimize valuable staff productivity, and further standardize ordering. This system showed noninferiority to the labor- intensive manual system while freeing up over 360 hours of staff time per year. I nventory management is both a major challenge and an integral part of hospital transfusion service (HTS) and blood center (BC) operations. Efficient manage- ment of the inventory and the blood supply chain is crucial to ensure safe, high-quality operations. 1,2 In the blood supply chain, failure to ensure sufficient product availability can potentially impact patient care, including having procedures delayed or even leading to patient injury or death. On the other hand, holding surplus stock can lead to untimely wastage of limited lifesaving resour- ces and health care dollars. Health care supply chain man- agement presents vast opportunities to eliminate wastes, remove excess costs, and, in the meantime, increase effi- ciency and effectiveness. 2-6 Along the health care supply chain, ideally, all the interwoven business activities and ABBREVIATIONS: BC 5 blood center; CRYO 5 cryoprecipitate; FP 5 frozen plasma; FTE 5 full-time equivalent; HTS 5 hospital transfusion service; PCs 5 product categories; T:S 5 ratio of units transfused per week to the number stocked; VMI 5 vendor-managed inventory. From the 1 Department of Laboratory Medicine, University of Washington, Seattle, Washington; and 2 Stanford Hospital Transfusion Service; 3 Stanford Blood Center, Stanford Health Care, Stanford Medicine; and the 4 Department of Pathology, Stanford University School of Medicine, Stanford, California. Address reprint requests to: Hamilton C. Tsang, Depart- ment of Laboratory Medicine, University of Washington, Seat- tle, WA 98102; e-mail: Hamiltn@uw.edu. Tho D. Pham, Stanford Hospital Transfusion Service, Stanford Health Care, Stanford Medicine, Stanford, CA 94305; e-mail: thopham@stanford.edu. Received for publication January 11, 2018; revision received February 15, 2018; and accepted February 15, 2018. doi:10.1111/trf.14766 VC 2018 AABB TRANSFUSION 2018;00;00–00 Volume 00, April 2018 TRANSFUSION 1