158 Chapter 4 their logistic services for other (commercialization) purposes, to name a few, but it will be up to each BE to choose contextually appropriate strategies. The strength of this study is the consolidation of various themes, representing drivers of RBC demand, and further confirmed by experts from the field. As this cumulative work was an intensive, international exercise, it need not be repeated but used as a starting point for other BEs and modified accordingly in multiple ways. For example, BEs could use their own experts to brainstorm, reorganize/rename, and/or re-rank the themes; themes could be taken as is or specific ones chosen for tailored mitigating measures to be created. This exercise could certainly be done on a smaller scale so that any sized BEs, including those with limited resources, could use this approach and/or the results provided. If anything, mapping various themes on an importance- uncertainty matrix provides a framework that is customizable for any particular context or region, which would save time and costs. Limitations of this study include the composition of the experts: many were Sanquin employees (particularly in Steps 2 and 3), functioning in roles of research and/ or management which could have influenced their ranking of internal issues within the organization and the scope of their expertise (e.g., less contact with hospitals/ patients). Including more non-Sanquin clinicians would have been valuable in these steps. However, this reiterates the fact that this exercise can be repeated and adapted in multiple ways so that results are most applicable to them. Future research opportunities include finding robust organizational strategies that would do well in various scenarios in which the effects of multiple drivers are concurrently considered, in accordance with traditional scenario methodology. 4.5 Conclusion Using a scenario approach, we have identified 10 main themes that may impact the future demand of RBCs. Our results indicate that future organizational strategies should incorporate precision medicine and include mitigating strategies against future disruptive events. An adaptive policy strategy is recommended that encompasses elements of learning, flexibility, and adaptability. Whether in a crisis or not, it is vital that an organization’s internal milieu reflect an innovative mentality and organizational agility, strong internal and external collaborations, and the public trust as vital to a BE’s operations. Therefore, a BE needs to shift from being reactive to proactive, increasing the organization’s preparedness for various future developments.
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