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Enhancing hemotherapy safety through pertinent diagnostic testing and electronic “provisional diagnosis” reporting: expanding roles for blood bank technologists in biovigilance and patient safety
Author(s) -
Andrzejewski Chester,
O'Hearn Lynne,
Rock Joan,
Passanisi Kelly,
Eaton Lynn,
Knee Alexander,
Edappallath Susmitha,
Merola Michael,
Cloutier Darlene,
Visintainer Paul,
Johari Vandita
Publication year - 2018
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1111/trf.14769
Subject(s) - hemotherapy , medicine , patient safety , anesthesiology , emergency medicine , blood transfusion , quality management , medical emergency , health care , surgery , anesthesia , operations management , management system , economics , economic growth
BACKGROUND Suspected transfusion reaction (STR) investigations are foundational for biovigilance. Diagnostic evaluations performed by blood banks may prolong turnaround times (TATs) for final STR results reporting. We identified a quality improvement opportunity using diagnostic testing reflex algorithms and our hospital's patient electronic health record to enhance TATs regarding one aspect of STR results reporting. STUDY DESIGN AND METHODS We conducted a descriptive quality improvement study of reported STR cases investigated by our hospital's blood bank from March 1, 2014, to December 31, 2016, using data obtained from consult reports/quality improvement databases examining the number and types of diagnostic algorithm reflex activations performed and the TATs for an electronic provisional diagnosis reporting (PDXR) related to them. RESULTS A total of 461 STR events occurred during the study interval, of which 150 involved no reflex testing. In the remainder of cases (n = 311), a total of 448 reflex activations occurred. In those cases in which PDXR occurred (n = 446), the median PDXR TAT during the first month of implementation was 325 minutes, which progressively decreased to 70 minutes or less approximately 1 year after implementation. By the last quarter of 2015, median TATs were 60 minutes or less in length, where they remained for the duration of the study. CONCLUSION Technologists using targeted diagnostic reflex arcs to expedite laboratory testing along with STR electronic PDXR improve communication and timely results/information dissemination, potentially aiding bedside hemotherapy‐related clinical decision making.