Technical Director Midwest Region Advocate Health Northbrook, Illinois, United States
Background/Case Studies: As part of a large Midwest hospital system, electronic crossmatch (EXM) has been in use for over 15 years but requires a confirmation blood type sample (ABRHC) or a historic blood type in order to qualify for EXM.Although a validated electronic verification system is allowed, our organization had struggled to identify a reliable way to complete the Positive Patient Identification (PPID) process.As part of a Hospital Information System (HIS) update, information was shared that the specimen collection information would now be visible in the HIS for all samples collected.It was now possible to see in the HIS if the PPID was performed, was overridden or was not utilized. Next steps were to validate the different scenarios that might occur so that the information in the HIS would be clearly show when PPID was used or not.
Study
Design/Methods: Different types of collection documentation were evaluated, and it was determined that there 3 types of collections that needed to be evaluated: Phlebotomy, Nurse and Clinic/ Outpatient.Sample collections were followed for the override process as well as successful specimen verification using PPID.These different types of collection processes were then viewed in the HIS so that it was clear how the documentation appeared in the different scenarios. Data was manually tracked at one of the locations to see what the impact of the new verified process was on the need to collect a 2nd sample.
Results/Findings: Phlebotomy team used mobile printers which showed that the patient ID was collected at the time of printing labels as well as verification of the samples with the patient post collection.Override was seen if either of these steps were manually bypassed. Nursing collections showed that the labels were printed but samples were then verified at the bedside post collection.Outpatient and clinic samples were found to not be able to utilize the PPID.The verification process was not turned on for outpatients as many locations did not have patient ID bands placed on the patients in this setting.Data showed that for 378 ABRHC tests performed, 262 utilized PPID and did not require the 2nd collection. Conclusions: Having 69% fewer collections required for this test is a huge success but data needs to be evaluated by collection area so that further education can be shared with those areas that are not using the PPID process.Phlebotomy time is a huge expense as well as the additional cost of the supplies (tubes and needles).Data is difficult to obtain for collected versus tested, as the ABRHC testing has be performed on the same sample even if PPID is used and it has been difficult to pull out just the collection piece.Additional sites will be evaluated to see if the PPID process is as successful as the one site that was able to pull the manual data.
