Presurgical Blood Bank Specimens and Meditech

[lab217]

Our blood bank is in the process of transitioning from Sunquest to Meditech in our hospital.  We are mapping our processes and are having a difficult time with our pre-surgical process.  We type and screen patients that have not been transfused or pregnant up to 14 days prior to surgery.  Meditech doesn't allow to issue units on this account and is suggesting that we order a new "order" also on the day of surgery account.

 

Is any other Blood Bankers on Meditech dealing with this issue and if so, how does your process work?

[Abraham]

We perform the type and screen on the Pre Admission account number and on day of surgery order RBC on the new surgical account. We do this mostly for billing reasons not becasue meditech does not allow it.

[pbaker]

We have a separate test called a P Neg (pretesting negative) that gets ordered day of surgery.  Assuming the patient has not been pregnant or transfused (answers to those questions are part of the p neg test) and the pretesting screen was negative, all that is performed is an ABO/Rh.  However it was built (not by me) Meditech accepts that result as the screen and allows us to issue units to that P neg specimen.  We do pre testing up to 30 days out.

[macarton]

We are Meditech 5.66 and we give our preadmissions a RCR # that is converted to inhouse once they come in for surgery.  Our outpatient chemo and infusion clinic also get the same type in patient # with status RCR.  This number is used for the current month.  It does cause problems with crossmatches done of the last day of the month with that months # and transfused on the first of the month since they are given a new #.  Billing moves the charges to the new account after they go home.

[Dr. Pepper]

We also went from Sunquest to Meditech (may the Lord have mercy on your souls). We do as Abraham does, type and screen on the preadmission account and crossmatches on the surgical account. The surgical accounts are created in advance for the day of surgery. We have had date of service issues with 3rd party payers when doing crossmatches today on an account that starts tomorrow, because the blood charges, even though issued tomorrow, are attached to the earlier specimen number date. It's a problem with outpatient transfusions, and fiscal has to move the blood charges to the actual date of transfusion. We have not seen the problem with surgical patients, I think because transfused surgical patients always get admitted and become DRG patients so no one cares how much blood you gave them nor looks at the posted dates.

 

You may also want to go with electronic crossmatches in version 5.66. If your patient qualifies, then don't bother actually doing the "crossmatches" until they want the blood on the day of surgery.

[BankerGirl]

We also went from Sunquest to Meditech (may the Lord have mercy on your souls).

 

AMEN!!  Best of luck adjusting!

[rravkin@aol.com]

Lab217, we use Meditech and have confronted the same issue. However, we rarely confront this situation on 3rd shift but I will try to remember and explain. We order a current Type and Screen and with the new order we delete the Type and Antibody Screen parts and result the history and crossmatch. We also have ordered as part of the product order, a No Charge product order. So here's what we do, after deleting the Type and Antibody Screen we result the crossmatch and TNP the No Charge Crossmatch which generates a current lable; then we result in the original PAT order the crossmatch in the No Charge section and TNP the crossmatch section. Are you as confused as I am yet? In any event, what we are able to generate are two labels for the same unit, the first reflects the crossmatch with the original PAT specimen and the second label reflects the crossmatch with the current order. I hope this helps a little. (Note: our PAT patients are our version of the same patients that you have " not transfused or been pregnant for up to 14 days")