Type & screen in the ER

[pbaker]

In our ER 40% of all the type and screens performed are on patients who are not admitted and receive no blood products.  Many of our diagnoses are things like weakness and dizzy.  Even had one diagnosis of insect bite.  Does anyone else have "statistics" of the number of TS performed in your ER and are they for real reasons or just because?  Since there is really no diagnostic value to a TS, I think we do too many.

[John C. Staley]

Do you have a transfusion committee?  If so, they might be a good one to bring this to their attention.  Also, if possible you might want to check, if you computer system is capable, and see if it is a generalized problem in ER or if you can pinpoint it to select physicians.  Another suggestion would be to get your medical director involved, it always seems to go a little smoother if you can get doctor talking to doctor.  In this day and age doing unwarranted testing should not be the norm and I imagine it will be very difficult to get some one to pay for a T&S on a diagnosis of "insecet bite".

[tbostock]

I would do a "study" for 1 month to breakdown that 40% by diagnosis, admitting Hgb level, and physician. And then present the data to Tx Committee and send to the lead doc in the ED as John suggested above.

[goodchild]

It's also good to get copies of their protocols. Review where in their algorithm the type and screen should be and where it doesn't make sense for it to be.

[Likewine99]

I agree with all of the above posts.  Most of ours are legitimate T&S and John is right:  unwarranted testing isn't going to be paid for anyway.

 

Good luck with this pbaker!