Hi,

We currently use HCLL in conjuction with EPIC for our blood bank software. We also have a manual blood bank log to record our testing reactions and a card catalog of 3x5's that contain patient info, test results (not reaction grades), and xm units. I want to get rid of the log book as I think it causes more clerical errors and wastes time with having to put results in three different places. I want to migrate to just using HCLL and a 4x6 card that will allow us to put results and reaction grades directly on the card.

Have any of you done this before and how did you go about it? I was thinking that we would have two card catalogs for a while a "New" and "old" while new patients' would be started on the new 4x6 cards and returning patients would get a new card and we somehow affix the original card to it?

Thought? Pointers?

Thank you!

Just curious, but why even have a card catalog at all?  That was the first thing I got rid of when we computerized my last blood bank.  It took about a year, if I remember correctly, to move all the old info from the paper records into the computer.  One thing we did was research each patient that we had not seen in over a year to see if they were deceased or assumed they were if over 100 years old and not seen for a certain period of time.  It made no sense to fill space in the computer with patients who were obviously no longer with us.

I didn't work at my current lab when they brought BB software online. I am suspecting that the continuation of triple documentation is out of habit rather than need. I am trying to bring fresh eyes to the situation, I may very well bring up the fact that we could go completely digital. However, I'm taking baby steps right now, especially since our "mother" hospital also still employs the card catalog with the same software and they are 2x bigger than we are.

2 hours ago, John C. Staley said:

Just curious, but why even have a card catalog at all?  That was the first thing I got rid of when we computerized my last blood bank.  It took about a year, if I remember correctly, to move all the old info from the paper records into the computer.  One thing we did was research each patient that we had not seen in over a year to see if they were deceased or assumed they were if over 100 years old and not seen for a certain period of time.  It made no sense to fill space in the computer with patients who were obviously no longer with us.

The NHSBT decided to go over to National Standard Operating Procedures, and that these should be "computer only"; so, apart from the SOP's being so generic as to be completely useless to man nor beast, I asked what would happen if the computer went down, and we had to perform a procedure that was unusual, such as a DL Test.  I was told that the country was divided into three areas (computer-wise) and that we could contact one of the other two for the SOP, but all three going down at once would NEVER happen.

Guess what happened about three weeks later?

While I don't agree with everything being kept as a paper record, certain SOP's that are rarely used, and up-to-date antibody records (given that, for many hospitals, this would not be onerous, are exceptions.

My facility also has HCLL/Epic. We have manila folders/envelopes to keep full workups on patients with antibody histories. You can always refer to the full panels and order of testing when doing crossmatches or new workups. Filing cabinets sort them alphabetically, and recently we purged folders of patients who were pretty old. Theoretically, anyone could go fully digital, but it's a downtime record for now. We have a backup server that stores preliminary testing data that we check periodically throughout the day to see if T/S information crossed over. That way, if HCLL is down, you can see typing results there. No paper records exist for patients without antibodies. 

20 hours ago, MDJones said:

I didn't work at my current lab when they brought BB software online. I am suspecting that the continuation of triple documentation is out of habit rather than need. I am trying to bring fresh eyes to the situation, I may very well bring up the fact that we could go completely digital. However, I'm taking baby steps right now, especially since our "mother" hospital also still employs the card catalog with the same software and they are 2x bigger than we are.

One thing I discovered in my many years as a Transfusion Service Supervisor is that inertia is the most powerful force in the Universe!  Trying to initiate change, especially in blood banking can be extremely difficult, often impossible.  Pick your battles carefully and make sure they are worth fighting.  Good luck.  

We use HCLL with Epic.  Our instrumentation is interfaced to HCLL (now WellSky).  For manual testing (tube, gel) reactions are entered directly into HCLL - tubes or gel card must be in hand when recording.   We do use paper for downtime and of course recording our antibody panel reactions.  There are a few tests that are wonky in HCLL that are easier to record on paper.  We also utilize the APBC (which backs up every minute) for when we are down. 

Here's an example of a front and back card used in a Transfusion Service without a computer system.  (Was all manual but relatively small operation). The cards were closer to 6x8.   Designed using Excel, then printed onto 8 1/2 x 11 cardstock with standard lab printer (front, then back, then cut in half & trimmed to fit the box.  (Low budget).   I can email to you directly if the scans don't come out very well. All results were written directly on the cards with all crossmatch and transfusion info on the back. 

Lab subsequently closed and transfusion service went back to central blood center.