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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
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  • Chester Andrzejewski, MD, Baystate Health
  • Lynne O'Hearn, Baystate Health
  • Joan Rock, Baystate Health
  • Kelly Passanisi, Baystate Health
  • Lynn Eaton, Baystate Health
  • Alex Knee, Baystate Health
  • Susmitha Edappallath, Baystate Health
  • Michael Merola, Baystate Health
  • Darlene Cloutier, Baystate Health
  • Paul Visintainer, Baystate Health
  • Vandita Johari, MD, Baystate Health
Document Type
Article, Peer-reviewed
Publication Date
7-1-2018
Abstract

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.

PMID
29984417
Citation Information
Andrzejewski C Jr, O'Hearn L, Rock J, Passanisi K, Eaton L, Knee A, Edappallath S, Merola M, Cloutier D, Visintainer P, Johari V. Enhancing hemotherapy safety through pertinent diagnostic testing and electronic "provisional diagnosis" reporting: expanding roles for blood bank technologists in biovigilance and patient safety. Transfusion. 2018 Jul 8.