The OrbiSac system: results and organizational impact.

BACKGROUND AND OBJECTIVES Growing health care demands, the uneven distribution of requirements for highly specialised services and the limits to the resources available to ensure an adequate response to the health care demands all make clear the managerial and macroeconomic need to adapt the organizational set-up of the health care facilities, redistributing the productive activities and care services in the territory, to meet the demands. We also found that it had become necessary to identify a different organizational model from the one in use in order to match the availability of platelet concentrates to the dynamics of the increased requests for this blood component in the setting of an Interhospital Immunotransfusion Department that involves the hospitals of Rimini, Forlì and Cesena. METHODS Observational and statistical methods were used to determine the production, productivity, efficiency, efficacy and cost-benefit ratio of the production of platelet concentrates and the appropriateness, with respect to the dynamics and territorial distribution of the requests, before and after a profound procedural and methodological reorganisation which included centralisation of the production and the adoption of an automatic instrument for processing platelets from buffy-coats (OrbiSac System). RESULTS The reorganization enabled the Department to reach almost complete self-sufficiency, to produce concentrates with a platelet content conforming with the indications of ministerial decrees, to uniform the quality of this blood component within the Department and to improve the use of human resources.