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I attended a Red Cross seminar yesterday and this was one of the topics. Many confilicting reports, no consensus in studies as to what constitutes "fresh" vs "old" rbcs. 2 major studies in progress which may provide further insight. The Cleveland Clinic original article was by their anesthesia dept . . . the same department did another study (by the director) which concluded that the original study was flawed. Very interesting seminar.

I have been retired after 40 years as a blood banker and I miss my Pathlab Talk friends. I am back with my home email.

1. Community hospital with 140 beds. Active heme/oncology service, general surgery, orthopedic surgery, OB/Gyn, general medicine. Level 3 trauma. Transfuse approx 100 units RC-LR per month. We do approx 250 T&S each month plus prenatal panels. 2 & 3. Our STAT turnaround time for T&S is generous. We started out working for 90 minutes from time of receipt, which we now hit >95% of the time - avg time is 52 minutes. I've started turning the screws on that. Last year we started working on turning T&S around in 90 minutes from time of order. It's do-able, though we've found that most of our outliers are due to phlelobotomy times (phlebs draw all lab work). We receive our specimens unspun. The locations included are all inpatients, ER and Surgical Service. Problem patients (antibodies, patient not available for draw because he/she is in X-ray, etc) are excluded. 4. Primary method is the Echo. Our second type is done by tube, usually while the Echo is running the T&S. I don't differentiate between new patients and patients with history for data collection. 5. I monitor all STAT turnaround times (no I'm not a full time paper mover, I work the bench a lot and yes, it's difficult to find enough time). I do not have a blood bank information system, but Blood Bank orders come through our LIS and are reported through home-grown report forms via the LIS. That makes it possible for me to run turn around time reports through the LIS. We have the time for final report set at 90 minutes, so all outliers print - saves me a ton of time. I analyze for shift and test time (to final report). The phlebs have 15 minutes from time of order to get the specimen draw - I look at collection time as well as receipt time. I report out percentage of tests that hit the mark and average turnaround time for all shifts, which is a more positive way to look at the data than percentage that miss. I put the data on a graph - easy for everybody to see how we are doing. I look to see if a particular person is having problems. If so, I work with that person to see what we can do to improve their TATs. (I had a night tech who simply lost track of time, so I asked her to carry a timer in her pocket set for the end time on the Echo. Problem solved - TATs improved several %.) This is part of my quality report.