AUTOMATION The Generalists Workload Manager IMMUCOR USER GROUP - - PowerPoint PPT Presentation

AUTOMATION

The Generalists Workload Manager

IMMUCOR USER GROUP MEETING 2016

C Michelle Roye

MS(CLM), CLS, ASCP(MLS)

Objectives

 Discuss the challenges and potential

inefficiencies of a smaller transfusion service

 Describe the importance of audits and

how they can help a smaller transfusion service overcome these inefficiencies

 List different startegies to overcome these

challenges

About Us

Four St. Joseph hospitals in Northern California. Redwood Memorial Hospital Petaluma Valley Hospital Santa Rosa Memorial Queen of the Valley Medical Center Queen of the Valley Medical Center was founded in 1958 by the Sisters of St. Joseph of Orange. A Catholic non-profit, full-service diagnostic and therapeutic medical facility.

About Us

Queen of the Valley Medical Center is dedicated to the Napa Valley community, bringing Commitment to the Napa Valley

 Trauma Center

• Upcoming Urgent Care Center

 Cardiac Center  Oncology Services  Labor and Delivery  Therapy Center  Fitness Center

Queen of the Valley Medical Center Herman Pavilion

Transfusion Service Move-In Date November 16, 2014

Move to Herman Pavilion

Patient Census

 Increasing census  208 bed hospital with a fluctuating census daily

average of ~87 patients (and growing)

 Includes 36 ICU beds

Challenges

 Small Community  Staffing Restraints  The Generalist

• Cross-Cover

 Competencies/Training  Fluctuating Census

Strategies

Focus on Department Efficiency What needs to change to become a more efficient department? Evaluate efficiency within new Transfusion Service both automated and manual. Evaluate processes and test workload functions for the change in environment and staffing.

Different Approach

Purpose of Audit

Focus Operational Audit

1.

Determine ECHO Test Use

post-Laboratory Move

2.

Evaluate Bench Time and Test Performed

3.

Improvements Opportunities

4.

Improvement Plan/Steps

ECHO PLACEMENT

In-Line with Hematology Pneumatic Tube System around corner Easy Specimen Receipt Easy Processing

Testing Performed on ECHO

Current Tests

 Type and Screens  Weak D testing  DAT’s  ABID

• Ready ID
• Extend I/II

DATA

Tests 15-Mar 16-Jan ECHO ave daily tests 11 11 ECHO total tests 311 302 Manual Methods Cord 23 41 ABORh 5 33 DAT 22 30 ADC (average daily census) 87.5 91.3

In the Numbers…..

AUDIT: Test Volume Comparisons

Decrease in Tests performed on ECHO & Increase of Manual Tests Performed.

10 20 30 March January

DAT's

DAT Manual DAT ECHO

Tech Hours

Bench Hours

21.25 Hours Could CLS be performing other tasks? Hours

Mar-15 Jan-16 Total Hours

ABORh 0.25 1.7 1.95 DAT 3.7 5 8.7 Cord Screen 3.8 6.8 10.6 Total

21.25

Opportunity

9% 41% 50%

Total Hours

ABORh DAT cord

Of the 21¼ hours used on the manual tests, ~50% of those tests were hours used to perform cord screens.

Opportunity

Cord Blood Screens ABORh

Validate Cords on ECHO

Allow cross-cover generalist to attend to other departmental needs.

Encourage Staff to use ECHO

Test is less than 10 minutes. Can batch multiple blood types, if applicable.

Process Improvement Plan

 Cord Screen

• Validate on ECHO

 ABORh

• Train staff

 DAT

• Evaluate SOP
• Redundancies

 Re-Evaluate

STEPS

CORD VALIDATION

 Presented Data to Pathologist  Contacted Immucor

• Updates?
• Programming?
• Validation Forms?
• Suggestions?

 Validation  New Procedure

STEPS

ABORH

 Educate/Encourage staff as to Advantage  Email Staff

• Outcome of Audit
• Time Use

STEPS

DAT

 Procedural (Test Duplicated)

• Review for redundancies
• Update
• Retrain

Validation

Cord Screen

 Set up ECHO for “Pediatric” test  Washing specimens

• May cause false negatives

 K2 EDTA Cord specimen

• Most of the specimens test good
• Did generate error due to clots

 12x75 Test Tubes

• Advised by Immucor
• Transfer from EDTA
• All specimens ran with no errors.

 Preparation time

Training

New/Updated Procedures Training Oral Assessments Written Assessments Direct Observations Questions Sign-Offs

Re-evaluate

6 Months

 Rerun ECHO Statistics  Re-assess Manual Tests Performed  Review Data for changes in Manual Test  Review Data for changes in Manual Hours

*Best to run data on same months previously evaluated

QUESTIONS?