Let's change the Blood Bank world!

[Brenda K Hutson]

So, a little more information from my part of the world after reading all of the responses up to now (sorry for the length).

I mentioned that our IT department put a box right in the center of the Order field which clearly tells the MD whether or not he/she needs to Order a new Type and Screen (and FYI: in our Hospital, most of the orders are placed in HIS by the doctors; only occassionally by RNs except our numerous daily calls to have them order a Type and Screen when the MD didn't but should have; because they couldn't take the 2 seconds to look in the box; also, just an aside because someone else brought this up; for the most part, the person who answers the phone on our Nursing units will tell the Nurse to order a Type and Screen instead of putting us on Hold and making us talk to the Nurse, which then takes her/him away from their job also). Problem being, the doctors will not look at that box which is shaded and in the middle of the screen.

So another aspect I have seen people bring up here is the phone calls. There is also a way for them (doctors and nurses) to be able to tell if a patient already has blood products availabe (in this same system). They do however have to look in a different place than the Order field for that information (under Results). When I started here a couple of years ago, it was just as with everywhere else I have worked in my 27 years; we were constantly on the phone because of nurses calling to see if their blood products were available. It easily took 15% of our time on any given day. So, I decided it was time to put a stop to that (in that the reality is, they certainly don't call Chemistry and say "can you read off all of the results of that Chem. Panel that was ordered; or call Hematology and ask for the results of every test making up a CBC, including the differential).

So, I started by gathering data over a couple of months. I created a log where staff documented these phone calls (and yes, that does take their time but you have to look at the goal at the end, and nothing speaks louder than documentation). I then asked to attend a Nursing Management Meeting. I explained my/our frustration with these calls and that while I know it is easier for the "Nurse" to call us, it certainly wasn't easier for us (and brought up the issue of Nursing looking at Results for all of the other areas of the Lab, so why not the Transfusion Service).

Luckily, in spite of many decades of entrenched patterns, they were willing to listen!! In fact, I am left with the impression that they threatened the Nurses to within an inch of their life in that when/if they do "dare" call now, they start it out with a very meek "I know I am not supposed to call but...". And I have said (and told my staff) that if we can tell they really are trying to look at the field but are just not sure where to go or what to look for, that we should talk them through it (I know, not our responsibility but I am trying to meet them halfway and not go backwards with what we have accomplished).

Although I could probably add to the Thread "Just for Fun", some of those conversations (i.e. I am looking in ECHO and it says the blood is Ready but I just want to see if that means it is Ready)!! Otherwise, I told my staff that if they called asking if blood was available, they were to be "nicely but firmly" remind them that they are supposed to look that up for themselves.

More of my problem was getting some of my own staff to stop just going ahead and looking it up for them (they too were entrenched in habit; and I suspect, a little afraid that if they refused, so to speak, they would get in trouble with the Nurses; but I told them that if they reversed my hard work by lookiing it up in the computer for them, I would not fight that battle again and they would just have to keep being interrupted with the calls).

Ok, sorry to ramble on; but where we are at now, 2 years later is that other than the OR or a Nursing Unit where the patient is in urgent need of the blood and they are not seeing it available in the system (so just want an ETA), we rarely get phone calls anymore.

One battle down!!!

Brenda Hutson, CLS(ASCP)SBB