Description

PURPOSE

The purpose of this paper is to present the Phlebotomy App as a proposed development initiative at Warrington and to ask for the approval for the allocation of funding from the COVID-19 Capital Programme.

The funding will enable the introduction of a paperless, electronic system to monitor the blood collection process and tracking of samples from vein to laboratory at Warrington and Halton Teaching Hospitals NHS Foundation Trust (WHH), in the Emergency Department, Theatres and ICU.  

INTRODUCTION AND BACKGROUND

WHH recognises the impact that advancement of technology can have on service improvement and this is reflected in the Trust’s IM&T strategy with the aim to achieve Trust Health Information Management Systems (HIMS) level 6/7.  The Pathology Department has worked with IM&T colleagues when identifying service areas that can transition to an electronic system with ease and Phlebotomy is one such area.

The blood collection process (phlebotomy) is the first and arguably the most important step in the production of accurate laboratory blood test results, never at a more crucial time than during this current COVID-19 pandemic.  Unfortunately it is the one process that is not completely within the laboratories control and errors relating to a poor blood collection process, is probably our greatest source of laboratory error and of major concern.

Of the 450,000 requests for blood tests made every year, a significant proportion are rejected due to labelling issues and a large proportion require laboratory relabeling due to print quality issues with the request forms and sample labels. This results in processing delays and introduces additional patient risk from lab staff potentially mixing up patient labels.

These common errors and issues are shared in most NHS laboratories and in response to this, healthcare software providers have been developing applications for mobile devices using iOS or Android platforms that aim to ensure users follow a designated process every time to reduce the risk of error.

COVID-19

This deployment greatly reduces the infection control risk in both clinical areas and the laboratory.

With no paper request forms or labels, there is less handling of the sample at the point of care.  The pre-labelled sample tube replaces the need for ICE labels; the labels currently need printing, peeling and attaching to a blank sample tube.  Printing of the ICE forms is on occasion taking place outside of the clinical area – the phlebotomy app not only removes the risk of cross infection but also negates the practical challenge of undertaking this activity whilst wearing full PPE.  

Clinicians & Phlebotomists then place the pre-labelled samples into a rack allowing the laboratory to load them straight into the analyser without needing to touch the sample, delivering an unquestionable benefit during this COVID-19 pandemic. 

A risk in the blood collection process is ‘Wrong Blood in Tube’, the electronic checks built into the Phlebotomy app makes this incident virtually impossible.  As a result of the COVID-19 pandemic, the Trust has had to redeploy a significant number of clinical staff to unfamiliar wards, this risk is heightened whilst following the current process, adoption of the phlebotomy app will mitigate this risk.    

Scan4safety

Scan4Safety is a vital part of the government’s drive to make the NHS the safest and most transparent healthcare system in the world by using barcode technology in healthcare settings.  WHH has a dedicated project group to consider Scan4Safety initiatives and it is also included in the Trusts Use of Resources work following the Lord Carter Report.

The six official Scan4Safety demonstrator sites have not yet explored electronic processes for blood collection however, University Hospitals Plymouth NHS Trust have introduced the electronic process for ‘blood tracking’ transfusions.  The project overview can be found on Scan4Safety website which details the numerous benefits that have been realised from the introduction of the process. 

PROPOSAL DETAILS

The proposal is for WHH to introduce a paperless, electronic system to monitor the blood collection process and act as local demonstrator site for the Cheshire and Merseyside Pathology Network.  The Pathology Department at WHH has Executive approval to implement this process which will provide Cheshire and Merseyside with valuable learning and be a pivotal step in understanding the qualitative and financial benefits of introducing electronic systems.