(P-TS-55) Going Paperless: Implementation of New Blood Product Compatibility label

Blood products dispensed from Transfusion Services must have an attached tie tag or label that details the recipient’s identifiers, unit number, and crossmatch results if performed (AABB Standard 5.22.1). Transfusion Services at our institution eliminated the paper product ID tag (PTAG) that was affixed to dispensed blood products and replaced it with a new compatibility label that is directly adhered to the product bag.  The prior paper PTAG was problematic to print and costly to produce and evolved to serve primarily as a downtime form during computer downtimes, or for documentation in massive transfusions and transfusion reactions.  Given current electronic documentation functionality in the electronic health record (EHR) and the blood product administration module (BPAM), a new compatibility label and electronic transfusion reaction workflow were built as part of a recent blood bank information system (BBIS) upgrade.

Study

Design/Methods:

Transfusion Service leaders and Patient Safety identified key stakeholders impacted by sunsetting the paper PTAG. Workgroups from affected departments collaborated to redesign clinical workflows, including changes to the blood product verification process, massive transfusion protocol documentation, and transfusion reaction reporting. Workflow changes were detailed in updated policies and had to be approved by institutional leadership groups. The new compatibility label and electronic transfusion reaction workflow required technical builds which were completed by the BBIS (SafeTrace TX, Haemonetics, Boston MA) upgrade team as well as the EHR team (EPIC Systems, Verona, WI). Education and training was provided to transfusionists and Transfusion Service staff via updated training modules, videos, and tip sheets.   

Results/Findings:

The new compatibility label prints on 6” x 4” label paper and has a perforated 2” x 4” section at the bottom that can be torn off and used to document transfusions on downtime forms when electronic documentation is not possible, such as during massive transfusion protocols or EHR interruptions. Suspected transfusion reactions are now documented electronically on nursing flowsheets and providers enter transfusion reaction workup orders in the EHR that laboratory staff use to document and report results.The new compatibility labels cost 60 % less than the paper product ID tags, which will save approximately $14,000 annually.

Conclusions:

The success of the new compatibility labels is being measured by blood administration audit findings, customer complaints, safety incidents, and cost savings. Quality improvement projects and educational efforts are ongoing to make sure the new compatibility labels and electronic transfusion reaction workflow are used correctly.