Abstract
Background: Quality indicators in transfusion medicine are necessary for patient safety and customer satisfaction. The turnaround time (TAT) of issuing red blood cells (RBCs) has emerged as one of the important quality indicator.
Aim: To evaluate the turnaround time (TAT) for the blood components from the time the blood request is received in the blood bank to issuance of the blood. Cases with delayed TATs were further analyzed to determine potential causes for the delays.
Material and Method: A total of 104 emergency cases were issued blood using immediate spin cross match (ISCM) technique over a period of three months. The TAT was evaluated by a team of investigators using standardised electronic timers. Standard TAT was fixed as 30 minutes. Reasons for delayed TAT were found out and analysed
Result: Most of the emergency requests were from surgical departments (72%). Majority of the requests were completed within 11-35 min. 41.34% requests had TAT above standard of 30 minutes. Main causes for delay were improper filling of the blood request and improper labelling of the samples, multiple component demands, short staffing, inadequate or lysed sample.
Conclusion: In spite of the continual emphasis on quality control, it is a challenge to maintain Turnaround Time within acceptable limits even in emergencies. At the physician`s end, it is important to emphasise on the importance of proper filling of request form and sample labelling. In lab, Blood bank personnel should be trained to handle urgent requests by assigning them priority. Moreover, continued education of hospital staff is needed to improve TATs.
Keywords: Turnaround time, immediate spin cross match, quality indicator, root cause analysis , blood transfusion.
References
- Ashraf Dada Daniela Beck Gerd Schmitz. Automation and Data Processing in Blood Banking Using the Ortho AutoVue Innova System. Transfus Med Hemother.
- Binita Goswami, Bhawna Singh, Ranjna Chawla, V.K.Gupta, V.Mallika. Turn Around Time (TAT) as a Benchmark of Laboratory Performance. Ind J Clin Biochem. 2010;25:376–379
- Bloch DM. Computer-generated management tools for the clinical pathology laboratory. II. Computer-generated graphic work flow. J Med Syst. 1982;6:305-10.
- Breil B, Fritz F, Thiemann V, Dugas M. Mapping turnaround times (TAT) to a generic timeline: a systematic review of TAT definitions in clinical domains. BMC Med Inform Decis Mak. 2011;11:34.
- Brie A. Stotler, Alexander Kratz. Determination of Turnaround Time in the Clinical Laboratory. Am J Clin Pathol. 2012;138:724-729.
- Bruce A. Jones, MD; David A. Novis. Nongynecologic Cytology Turnaround Time. Arch Pathol Lab Med. 2001;125:1279–1284.
- Cheng G, Chiu DS, Chung AS, et al. A novel system for providing compatible blood to patients during surgery: ‘‘self-service’’ electronic blood banking by nursing staff. Transfusion. 1996;36:347–350.
- Cox C, Enno A, Deveridge S. Remote electronic blood release system. Transfusion. 1997;37:960–964.
- Jalili M, Shalileh K, Mojtahed A, Mojtahed M, MoradiLakeh M. Identifying Causes of Laboratory Turnaround Time Delay in the Emergency Department. Arch Iran Med. 2012;15:759–763.
- Memtombi Devi, A.Barindra Sharma, L.Dorendro Singh, Ksh.Vijayanta, S.T.Lalhriatpuii, A.Meina Singh. Quality Indicators of Blood Utilization in a Tertiary Care Centre in the North-Eastern India. Journal of Dental and Medical Sciences. 2014;13:50-52.Laboratory Medicine 0:0:1-5;48;277-281
- Lee AJ, Kim SG, Analysis of Turnaround Time for Intraoperative Red Blood Cell issues: A Single-Center Study
- McClain CM, Hughes J, Andrews JC, Blackburn J, Sephel S, France D, Viele M, Goodnough LT, Young PP. Blood ordering from the operating room: turnaround time as a quality indicator. Transfusion. 2013;53:41-8.
- Quality indicators of blood bank.www.nabh.co.>H.DOC>QIBB
- Ramanathan T, Shaiji. P.S, K.C. Usha. Turnaround time for issuing blood products in emergency-a prospective real time study in a regional blood transfusion centre. International Journal of Contemporary Medical Research 2017;4(3):688-691.
- Richard B. Weiskopf, Mary Webb, BS; Deena Stangle, BA; Gunter Klinbergs, Pearl Toy. A Procedure for Rapid Issue of Red Cells for Emergency. Use. Arch Pathol Lab Med. 2005;129:492–496.
- Robin T. Vollmer, MD. Analysis of Turnaround Times in Pathology. Am J Clin Pathol. 2006;126:215-220
Corresponding Author
Mitali Sharma
DOI: https://dx.doi.org/10.18535/jmscr/v6i11.42
