Background/Case Studies: The Blood Bank receives Type and Screen (T&S) and ABO/RH confirmation specimens on patients when they may require transfusion. The ABO/RH specimen is collected to confirm the patient’s blood type if the patient does not have a historical blood type in our hospital’s blood bank computer system. The Blood Bank recognized that many specimens were being collected unnecessarily, leading to duplicate and rejected specimens. The T&S order set in Epic was modified in August 2023 to default to a T&S order only if the patient had a historical blood type documented in Epic, with the ability to add on an order for an ABO/RH test manually if needed. The purpose of this project was to reduce monthly duplicate specimens and subsequently reduce phlebotomy and avoidable blood loss, reduce testing and improve patient care.
Study
Design/Methods: The Blood Bank worked with the IT department to implement an order modification on Epic. The number of duplicate specimens by month and location were evaluated and compared before and after order implementation.
Results/Findings: The Epic order modification was implemented in August 2023, with 2,350 duplicate specimens in August 2023 declining to 1,467 specimens in September 2023. This reduction in duplicate specimens continued in subsequent months (Figure A). Conclusions: Duplicate specimens are a common problem at many blood banks, and implementation of an order set change can have a significant impact on ordering patterns, specimen collection and avoidable blood loss. While we have experienced a reduction in monthly duplicate specimens, additional efforts are ongoing to evaluate ordering patterns by department and location to further reduce unnecessary specimens.
