30 Chapter 2 Furthermore, to “define the future,” it is beneficial for blood bank management to consider what transformational factors (broadly defined as any development in science, society, or technology) may have a significant impact on blood demand and to what effect. For example, the aging population may increase blood demand, with subsequent shortage,15–18 but it may also be mitigated by the effects of gene or immune therapy, even leading to a continual decline.14,19 However, predicting the effects of these transformational factors is difficult for its uncertainty. Current forecasting literature solely focuses on quantitative methods to predict the future demand of blood products,10,13,19–21 but because blood transfusion is a complex environment with uncontrollable factors and various stakeholders, quantitative predictions have limited reliability. Therefore, it may be beneficial to also include qualitative input, such as expert perspectives, to integrate knowledge, imagination, and even intuition, into forecasting literature.22,23 To the best of our knowledge, there is no current literature that assesses transfusion experts’ perspectives on the historical trends and drivers and the transformational factors that may impact the future demand for high-income countries. Therefore, as the first step of a larger project to predict the future demand of blood products in the Netherlands, we sought to explore and compare perspectives of various transfusion experts from the Netherlands and abroad to answer two research questions: 1. What were historical trends of RBCs in the past 20 years and underlying drivers to these trends? 2. What are transformational factors that would impact the future demand of RBCs for the medium term (10-20 years) and to what specific effect? 2.2 MATERIALS AND METHODS Semi-structured interviews From November 2017 to July 2018, 42 semi-structured interviews were held with Dutch experts (including Sanquin employees, clinicians, and other national experts) and abroad. Experts were purposefully selected for their specific role and experience in blood transfusion. If they agreed to participate, each interview lasted approximately 30 to 60 minutes and was recorded with consent. Further respondents were “snowballed,” a method in which prior respondents were asked to refer other individuals they thought would be appropriate for this study.
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