Posted January 12, 201213 yr comment_41281 We are working to streamline our workflow and bring in automation this year. We would like to start "batching" routine transfusion orders. What are others using for turnaround times for routine inpatient transfusion orders?
January 13, 201213 yr comment_41305 Our policy lists the turn around for a routine as 8 hours. Rarely is this the length of time it takes to handle routines. Our policy lab wide is 8 hours for routine, 4 hours for urgent, and 1 hour for STAT.
February 15, 201213 yr comment_41998 Our Blood Bank Policy allows an 8 hour turnaround time for routine, but experience has taught me that quite a few TS ordered routine becomes a stat orders. Thus we try to get all our routine TS done in a 2 hours. Stats - 1 hour.
February 15, 201213 yr comment_42008 We batch 3 times a day during core hours so 4 hours ish... 9 am, 1pm and 4pm. Anything non-urgent recieved overnight gets done at 9am. We actually don't quote turn around times for routine crossmatches as our policy states that, for routine 'top-up' or pre-op crossmatches, 72 hours notice should be given to allow full investigations to be completed should the patient have a new antibody.
February 15, 201213 yr comment_42028 When we first started using our automation (ABS2000 in 1999) the most difficult thing for my staff was letting a sample set on the counter waiting for a partner to share the strip with. Batching was a concept my staff was unfamiliar with. The general mentality seemed to be that "if I don't do it now and a AAA comes in then I'll really be in a bind". It too some time for them to come around but our batches were mostly driven by the technology, how many patients could we do and not waste any reagents so generally we did out paitents when we had an even number. There was no time we referenced and seldom did a sample set for more than a couple of hours. :juggle:
February 15, 201213 yr comment_42041 What is a "routine inpatient transfusion order?" Every transfusion, except pre-op is STAT; our hospitalists insist on everything now, our oncologists insist on everything now, ER insists on everything stat STAT.
February 16, 201213 yr Author comment_42042 Batching was a concept my staff was unfamiliar with. :juggle:Hi John! I hope to get my staff to realize that batching is NOT a bad thing, wasting reagents is. We get a lot of routine type & screens on patients coming in for pre-op testing. We can set them aside so all three shifts will have samples to add to that single "must have it now" order.
February 16, 201213 yr comment_42044 What is a "routine inpatient transfusion order?" Every transfusion, except pre-op is STAT; our hospitalists insist on everything now, our oncologists insist on everything now, ER insists on everything stat STAT.I think there are two ways of looking at it - I assumed the OP was talking about transfusion samples as it group&screens, and I think the other posters did too. I think your take was the TAT for an actual crossmatch. Maybe the OP could clarify.FWIW there is no such thing as a STAT crossmatch unless the patient is bleeding out. In almost every other situation the medics have plenty of time to organise themselves - they just choose not to
February 16, 201213 yr comment_42046 Auntie-D, I get the distinct impression that Bill's post was very tongue in cheek.I think he meant the there are no routine TRTs because EVERYONE always wants their tests to be done as a matter of urgency, whatever the clinical condition of the patient!
February 16, 201213 yr comment_42060 Auntie-D, I get the distinct impression that Bill's post was very tongue in cheek.I think he meant the there are no routine TRTs because EVERYONE always wants their tests to be done as a matter of urgency, whatever the clinical condition of the patient!You are exactly right, Malcolm.Also a comment regarding Antie-D's second paragraph: You are also correct. Similarly, a one-unit STAT crossmatch on an adult isn't going to save a life. We Blood Bankers know these things. However we are not the ones who order the STAT crossmatches, and we have virtually no control over those who order the STAT crossmatches (unfortunately.)
February 17, 201213 yr comment_42078 I think he meant the there are no routine TRTs because EVERYONE always wants their tests to be done as a matter of urgency, whatever the clinical condition of the patient!I know what you mean here - I was alone in the night doing a crossmatch on a premi baby with HDN for exchange transfuion and some numpty wanted 4 units straight away on someone with moderate epistaxis and a hb of 130. I explained my situation and he still insisted that I put his patient first! I transfered him to the consultant paediatrician and told them to sort it out between themselves (fight!) - funnily enough I didn't get another call
February 17, 201213 yr comment_42079 I know what you mean here - I was alone in the night doing a crossmatch on a premi baby with HDN for exchange transfuion and some numpty wanted 4 units straight away on someone with moderate epistaxis and a hb of 130. I explained my situation and he still insisted that I put his patient first! I transfered him to the consultant paediatrician and told them to sort it out between themselves (fight!) - funnily enough I didn't get another call Good for you!
February 18, 201213 yr comment_42101 We have a STAT board (looks like an airport arrival/departure screen) where all stats display. Type and Screens and XM's go from green to yellow at 45 minutes, and yellow to red at one hour. All of our surgicals are STAT, and they come in all day long. The board helps us be aware of specimens that might be lost or misplaced. We think one hour is fair for XM's without antibodies.
February 18, 201213 yr comment_42102 This is an age old Blood Bank question (not that I'm old or anything:p) but my thoughts are that you can monitor TAT's anyway that keeps the number counters happy but the most important thing is the right result, on the right patient as fast as humanly possible.The true test for BB TAT is how quickly can you get the products ready and out the door as in the case of a trauma pt or the open heart pt that has gone bad, or the baby that needs the exchange transfusion. And you know no one ever monitors those kinds of cases.
February 20, 201213 yr comment_42133 We use 90 minutes for STATs, though we almost always turn them out in 60 minutes or a bit less from time of order on the AM shift. Our routine turnaround time is officially 4 hours, but in actual practice is usually less. We use routines, prenatals, 'give it tomorrow' orders and pre-admission testing for 'twinning' on the ECHO. I agree with the sentiment that what matters most is doing the best you can for those who need it most - the traumas, the AAAs, etc. It's amazing how fast you can work when every minute counts. Doesn't mean we neglect everyone else, it just fixes our priorities. Edited February 20, 201213 yr by AMcCord
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