...Matthew Arless State University of New York Plattsburgh Blood loss in a total joint replacement surgery may subject the patient to allogeneic blood transfusion. This places a patient at risk for the potential of transfusion reactions, graft-versus-host disease, hyperkalemia, fluid overload, and infections.( Qintong 2014) Not to mention the fact that most patient’s satisfaction or even more significant avoidance of the surgery increases with the fear of receiving an allergenic blood transfusion. This in all sense and purposes is an organ transplant. Cost of an allogeneic blood transfusion and having a sufficient blood supply are also a factor. Reduction of blood transfusions post operatively is an area that presents an opportunity for improvement here at the Joint Care Center Champlain Valley Physician Hospital. The procedure that was traditionally implemented by most of the orthopedic surgeons at Champlain Valley Physician Hospital to reduce blood loss was with the use of a tourniquet during surgery to slow the loss of blood and the implementation of an auto transfusion device. This auto transfusion device would collect blood draining from the surgical site into a device that the nurses would then have to attach a PALL filter to for re-infusion back into the patient. This procedure would be treated under the transfusion protocol, using up valuable nursing time and with the added expense of the devices and restriction of the patients mobility due to this device. The latest...
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...1.) It seems that Providence Medical Center uses Evidence-based Management in the decision making for their whole organization. They are utilizing their tools to make changes within the organization, in turn involves better care for patients, saving patients money, and also saving the Hospital money. As Stanford business scholars Jeffrey Pfeffer and Robert Sutton said evidence based-management is based on the belief that “facing the hard truths about what works and what doesn’t will help organizations run better.” The Administration at Providence Medical Center encouraged all of the internal staff divisions to contribute their ideas to help lower costs and improve patient care. Since they were open to suggestions from all staff, they embraced the challenges of innovation. For example the nursing team came up with an idea to help reduce falls by patients when they are walking about in their rooms. Their evidence-based idea was a success and reduced the falls of patients. I think evidence based-management seems like a good way to run a hospital, or any type of or organization for that matter. The Management of the organization, company, ect. Develops ideas, and rationally decides which will be the most effective with what they are working towards changing. After putting their changes in motion, the company can check the results of their changes within a time frame, and then decide whether there is any evidence of improvement. 2.) Providence Medical Center implemented scientific...
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...available in the human blood market due to several disadvantages of the currently available alternatives. Even more opportunities exist in the animal blood market. Oxyglobin should be positioned as a high-quality product designed for middle- to upper-class budgets. The price for Oxyglobin should be about $200 for the consumer and around $100 for the supplier (animal hospital) to account for distribution markups and other carrying costs. Distribution should be oriented in the regional vicinity of the operation and implement larger clinics. In addition, only emergency clinics are to be targeted. Current opportunities are favorable for Oxyglobin’s launch. 2 Situation Analysis I. Human blood market. • Patients with acute blood loss from trauma and surgery – 40% individuals aged 65+. • Chronic anemia patients (any age) – 1.5 million for the year 1995. • Blood loss, resulting from trauma (e.g. car accident) and exceeding 2-3 units (1 unit = 10% of total blood content of human body) needs immediate blood transfusion. • Price is largely cost-based (storage, implementation) – blood donation is free. Existing options. • Red blood cells and their components (hemoglobin, platelets, and plasma) are collected via donations, organized by blood collection centers and then transfused...
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...Unexposed Dangers of Blood Transfusions Blood is not considered the “fluid of life” without valid reason. This essential liquid is circulated throughout the human body within veins, capillaries and arteries to our heart, where it is cleaned from contaminants and waste products, then replenished with nutrients and oxygen needed to maintain life. That is the way the human body system nourishes its cells. Blood provides the necessary nutrients to our cells to keep them alive. When this process is compromised by chronic blood loss, trauma, clotting abnormalities (hemophilia, anemia, etc.), the most common treatment is the use of blood transfusions. How wise would it be to consider all of the risk factors involved with blood transfusions before making a decision to utilize one? “There is increasing evidence that blood transfusions are dangerous and often unnecessary” (Hupston, “Quality Blood Transfusion Alternatives” 1). According to the article “Blood Transfusions- Risks”, published by the Mayo Foundation Medical Education and Research (MFMER), several risks are associated with blood transfusions. Included are the possibilities of getting an allergic reaction, even when the two blood types are compatible. Such reaction can cause from hives and itching to greater problems pertaining to breathing problems and blood pressure, tachycardia, vomiting, anxiety and fever. If a reaction of that nature occurs, the doctor will immediately order a ceasing of the transfusion, perform screening tests...
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...with patients. Some professionals confront the ethical issues directly while others turn away (Colonel John S. Murray, PhD, RN, USAF, NC, 2014). How individuals respond to these ethical dilemmas depends on their previous experiences with unethical behavior, their individual personality traits, and their ethical values, as well as their knowledge of ethical principles (Clancy, 2003). In this modern era, there are certain ethical issues that might arise in relation to a patient’s clinical management. A prominent medical ethical issue is the refusal of a patient for treatment, such as receiving blood transfusion because of his or her belief. The most renowned international religious group of people that refuse blood transfusions is the Jehovah’s Witnesses. Jehovah witnesses believe that blood transfusion "may result in the immediate and very temporary prolongation of life, but at the cost of eternal life for a dedicated Christian" (Jason Barker, 2000). In June 2000, the governing body of Jehovah’s Witness called the Watchtower Society changed its policy regarding members who choose to receive blood...
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...Portfolio Analysis: The Market Position Juanita Williams American Intercontinental University August 30, 2015 Dr. Christopher Miller Portfolio Analysis: The Market Position The decision making process among hospitals are very complex, therefore, it has become more prevalent to use a portfolio analysis in there strategic planning process. The portfolio analysis will help any organization address some of the obstacles they face such as the appropriateness and measurement of growth (McCain, 1987). It is an important aspect of evaluating when the organization has the idea to start a new project or not. In he portfolio analysis the services and products are being analyzed in relation to the market growth and the market share (AIU, 2015). It is best to know who your biggest competitors are and also know who holds the biggest share of the market. Once this is known then these should be compared to all other competitors and see what the market growth is. Health care organizations will use the portfolio analysis not only to look in to their services and products provided, but into all of the organization’s department. We will take a look at how the Sisters of Charity Hospital can use a portfolio analysis within their market for growth. The hospital is located in Columbia, South Carolina as well as Cleveland and Canton, Ohio. This organization provides many different services such as service for the elderly, blood conservatories...
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...Biopure Corporation: A Case Study Biopure Corporation specializes in blood substitutes for transfusion patients, both in the veterinary market and the human market. However, in 1998, Biopure faced the monumental decision of whether to begin selling Oxyglobin, a blood substitute, to the veterinary market or to wait until Hemoglobin, a blood substitute for the human market, became available for sale. Biopure’s problem was simple: should the company launch Oxyglobin before Hemoglobin is FDA-approved or wait until after Hemoglobin is approved and released into the human market. Ted Jacobs, vice president for Human Clinical Trials at Biopure Corporation, argued that Oxyglobin should be released later because Hemoglobin would not be able to be priced at such a high rate if the same product (for a different market) was charging much less. However, Andy Wright, vice president for Veterinary Products at Biopure Corporation, countered that Oxyglobin would increase the market and make people familiar with the Biopure name, thereby giving the company competitive edge in the human market. Our recommendation is to release Oxyglobin immediately rather than wait for Hemoglobin’s FDA-approval. The reasoning behind this decision follows from an analysis of both the veterinary blood substitute market and the human blood substitute market. Reasons to release Oxyglobin immediately are summarized in Exhibit A. This conclusion requires the Oxyglobin marketing team to make several subsequent decisions...
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...that only 2.5% of those 12 million dogs (the “critical cases”) are actually transfused with four units of blood, each. An additional 3.51 million dogs stand to benefit from blood or blood product transfusion, resulting in a net potential market of at least 3.87 million units of blood or blood replacement product. Naturally, neither every dog, nor every pet owner, nor every veterinarian will achieve 100% of the potential consumption. Biopure, with a production capacity of only 300,000 units of Oxyglobin, cannot satisfy the total potential market, but the potential market instructs not only the marketing plan but also the pricing strategy for Oxyglobin. Based on market research including willing-to-pay surveys of both veterinarians and pet owners, and based on the full potential of the market, a veterinarian (wholesale) price of $200 per unit is recommended (retail, or billed, price of $400). The market for Oxyglobin based on Biopure market research is 138,353 units. Revenue from this model would be $27.7 million, assuming capture of 39% of the existing, “critical case” market. Revenue maximization would result at $100 per unit cost, with maximal revenue of $127 million. Maximum revenue realization would necessitate not only perfect market adoption among the entire 30% of transfusion-eligible dogs, but also a production capacity of over 1.2 million units of Oxyglobin per year. The current...
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...BIOPURE Corporation. 1. Give your best estimate of the sizes of Biopure’s market, potential market, and what you recommend as the target market in the animal market? Do the same for the human blood market? Who are these people (or animals)? Since the definitions of these different markets can be vague, it may be useful to operationalize these concepts in terms of circles on a target which represent the likelihood of being a customer and when they should be targeted by the company. Thus, the “target market” (center) would be those customers whom the company should try to attract now since the product could/should have strong appeal at the present time. Or, another useful way might be to describe each group, its size, and the probability that that group will be a prospect (and then explain why). The discussion of target market selection on pp. 48, 72-74, & 231 in the textbook may help. The “market” would include the target market but would also include those who are either less likely to benefit now from the product and/or should not be targeted at this time for some reasons (e.g., the amount of resources available). The potential market would include the above but also other segments that would have much less need or ability to recognize their need at some time. Note that there are likely multiple segments with decreasing likelihoods of adopting the product at any time, depicted in outer rings of the target. Potential Market – Set of consumers who have a sufficient level...
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...critical care review Transfusion-Related Acute Lung Injury* A Review Mark R. Looney, MD; Michael A. Gropper, MD, PhD, FCCP; and Michael A. Matthay, MD, FCCP Transfusion-related acute lung injury (TRALI) is an underreported complication of transfusion therapy, and it is the third most common cause of transfusion-associated death. TRALI is defined as noncardiogenic pulmonary edema temporally related to transfusion therapy. The diagnosis of TRALI relies on excluding other diagnoses such as sepsis, volume overload, and cardiogenic pulmonary edema. Supportive diagnostic evidence includes identifying neutrophil or human leukocyte antigen (HLA) antibodies in the donor or recipient plasma. All plasma-containing blood products have been implicated in TRALI, with the majority of cases linked to whole blood, packed RBCs, platelets, and fresh-frozen plasma. The pathogenesis of TRALI may be explained by a “two-hit” hypothesis, with the first “hit” being a predisposing inflammatory condition commonly present in the operating room or ICU. The second hit may involve the passive transfer of neutrophil or HLA antibodies from the donor or the transfusion of biologically active lipids from older, cellular blood products. Treatment is supportive, with a prognosis substantially better than most causes of clinical acute lung injury. (CHEST 2004; 126:249 –258) Key words: ARDS; lung injury; pulmonary edema; transfusion; transfusion-related acute lung injury Abbreviations: ALI acute lung injury;...
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...better to lose a battle and win the war, rather than ruing the day’, a similar situation awaits Biopure. A solitary decision over a timely product launch would either allow them to capitalize on a market or lose the ‘war’ in the competitive field of blood transfusion substitutes. The idea of using blood substitutes as a replacement for the existing traditional methods of blood transfusion stemmed from the complications associated with the acquiring, handling and storing of whole blood. Biopure Corporation was one such company which had produced two products, Oxyglobin and Hemopure, both of which were bovine derived hemoglobin products. The advantages of these products over classic blood transfusion techniques included elimination of blood typing, cross matching and refrigeration steps, higher oxygen carrying capacity, increased shelf life of 2 years along with infectious and contamination free products as an end result. In addition, Oxyglobin was approved by the FDA. Owing to the privilege of being the sole supplier of blood substitutes in the veterinary industry, it had a huge potential to monopolize the market. The lack of competitors would generate a significant amount of revenue from which they could recover the development cost and would simultaneously allow Biopure strengthen their position in the market in case Hemopure gets approved by the FDA in the near future. Due to the aforementioned salient benefits, launching Oxyglobin seems logical and at the same time, a strategic...
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...The Problem: Biopure Corporation has two new products that are Oxyglobin and Hemopure. Oxyglobin is the first new blood substitute for the veterinary market and is ready for consumer use. Hemopure is another new blood substitute for the human market and it will take two years to launch the product from now on. Ted Jacobs, vice president for Human Clinical Trials, is concerned about creating an unrealistic price expectation for Hemopure by marketing Oxyglobin before Hemopure. On the other hand, Andy Wright, vice president for Veterinary Products, believes that selling Oxyglobin has benefits for the company in terms of generating revenues for the use of launching Hemopure and learning how to market and make mistakes prior to the launch of Hemopure. Carl Rausch, the president and CEO of Biopure Corporation, has to decide if the release of Oxyglobin would be beneficial for the company without jeopardizing the potential of Hemopure. The Solution: I think that launching Oxyglobin has many benefits for the company. For this reason, I agree with Andy Wright’s decision to begin by selling Oxyglobin. Ted Jacobs indicates that the veterinary market is small and price sensitive. He also believes that if the company prices Oxyglobin around $150, it will be very difficult to price Hemopure at $800 because of the huge difference in price for the same product. I disagree with Ted Jacobs because although the production processes and physical characteristics of these two products are identical...
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...1. Introduction Acquired immunodeficiency syndrome, also known as AIDS, is caused by human immunodeficiency virus (HIV).HIV damages body’s immune system by destroying white blood cells which help us to destroy invaded pathogens. When HIV enters a white blood cell, it may remain dormant. However, once it is activated, it infects another cell to produce many new HIVS. After a certain period of time, the white blood cells are destroyed and leading to a loss of function of the immune system (Y.K. Ho,2004). People infected by HIV will turn out to have AIDS. Infected people are very weak to fight off other infectious disease and soon they will die. According to the data and statistics of WHO, global summary of the AIDS epidemic, 2009, the number of people living with HIV is around 33.3 million and AIDS death in 2009 is around 1.8 million. How about China situation? We couldn’t find much data about China situation. Therefore, we have to explore the situation from other sources. 2. Current Situation of AIDS in China According to the ministry of health of the people’s republic of China, the number of people living with AIDS is about 370 thousand and AIDS death is about 60 thousand. The figure is much different from the prediction of United Nations (UN), UN predicted that there will be 10 million people living with AIDS at the end of 2010. So, which figure is more reliable? I would suggest the UN one and the following is my reason. In the early 1990s, the Chinese leadership...
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...BIZ2120: Marketing Case analysis #1: Biopure Corporation Submitted by MARCO TARANTA ID: 2013843468 SEMESTER: Fall 2013 1. What is the potential market size for each of Oxyglobin and Hemopure? The veterinary market is valued at $638,550,000. Since the expected market share for Biopure is 100% and assuming that the total U.S. veterinary practices (15,000) remains the same, we can state that the potential market size for Oxyglobin is $638.550.000. The main segments in the veterinary market are “Primary Care” and “Emergency Care”. The veterinary practices are approximately 15,000, 95% of which are Primary Care and 5% Emergency Care. Furthermore, the average of transfused blood units in each Primary and Emergency practice is 17 and 150, respectively. The potential market size is based on roughly 4,257,000 blood units. In the case, it is specified that only 354,750 units are actually transfused in particular cases deemed critical. Thanks to its innovative benefits, Oxyglobin is able to break through the barrier and reach the potential units which correspond to the revenue shown above. However, we must point out that the price to compute the expected revenue is open to variations. In fact, Oxyglobin can be priced up to $200 per unit considering that a survey shows that a high percentage of pet owners are willing to be fully aware of...
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...middle- to upper-class budgets. • The price for Oxyglobin should be about $200 for the consumer and around $100 for the supplier (animal hospital) to account for distribution markups and other carrying costs. • Distribution should be oriented in the regional vicinity of the operation and implement larger clinics. In addition, only emergency clinics are to be targeted. Current opportunities are favorable for Oxyglobin’s launch Situation Analysis I. Human blood market. • Patients with acute blood loss from trauma and surgery – 40% individuals aged 65+. • Chronic anemia patients (any age) – 1.5 million for the year 1995. • Blood loss, resulting from trauma (e.g. car accident) and exceeding 2-3 units (1 unit = 10% of total blood content of human body) needs immediate blood transfusion. • Price is largely cost-based (storage, implementation) – blood donation is free. Existing options. • Red blood cells and their components (hemoglobin, platelets, and plasma) are collected via donations, organized by blood collection centers and then transfused into patients. • Current options allow for storage for 6 weeks in refrigerated conditions, consequently disposed of if unused. Hemoglobin uses oxygen-carrying efficiency by 50% if not used within the first few weeks. • Blood transfusion is subject to blood typing (A, B, AB, O, positive, negative) and reception/rejection by the body. Incorrect matching may be fatal for the patient. • Infection risks slow down the process of testing...
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