Prioritizing Barriers to Resilience in Blood Supply Chains: An Integrated Multi-Criteria Decision-Making Approach

Abstract Supply chains face numerous disruptions in today's dynamic world, and achieving resilience is vital for healthcare systems, especially in the blood supply chain (BSC). However, there are several barriers hindering resilience, and identifying and prioritizing them is essential for developing effective strategies to improve resilience. This study proposes an integrated multi-criteria decision-making (MCDM) approach that combines the Best Worst Method (BWM), Delphi, and Preference Ranking Organization Method for Enrichment Evaluation (PROMETHEE) to recognize and prioritize SC resilience barriers in the BSC of Tehran, the largest BSC in Iran. The proposed approach provides real-time results for future improvements, and sensitivity analysis investigates the effects of criteria weights on decision-making. Additionally, the proposed method is compared with two existing methods, namely BWM- VlseKriterijumska Optimizacija I Kompromisno Resenje (VIKOR) and BWM-Weighted Aggregated Sum Product Assessment (WASPAS). The results demonstrated that the most critical barriers are a lack of financial resources and the presence of managerial weaknesses at various levels. By highlighting these barriers, the study provides valuable insights for decision-makers to develop effective strategies and allocate resources to address the identified obstacles and improve the resilience of the blood supply chain.