Benefits of VISION Max automated cross-matching in comparison with manual cross-matching: A multidimensional analysis

Abstract

BackgroundVISION Max (Ortho-Clinical Diagnostics, Raritan, NJ, USA) is a newly introduced automated blood bank system. Cross-matching (XM) is an important test confirming safety by simulating reaction between packed Red Blood Cells (RBCs) and patient blood in vitro before transfusion. We assessed the benefits of VISION Max automated XM (A-XM) in comparison with those of manual XM (M-XM) by using multidimensional analysis (cost-effectiveness and quality improvement).Materials and methodsIn a total of 327 tests (130 patients), results from A-XM and M-XM were compared. We assessed the concordance rate, risk priority number (RPN), turnaround time, hands-on time, and the costs of both methods. We further simulated their annual effects based on 37,937 XM tests in 2018.ResultsThe concordance rate between A-XM and M-XM was 97.9% (320/327, kappa = 0.83), and the seven discordant results were incompatible for transfusion in A-XM, while compatible for transfusion in M-XM. None of the results was incompatible for transfusion in A-XM, while compatible for transfusion in M-XM, meaning A-XM detect agglutination more sensitively and consequently provides a more safe result than M-XM. A-XM was estimated to have a 6.3-fold lower risk (229 vs. 1,435 RPN), shorter turnaround time (19.1 vs. 23.3 min, P < 0.0001), shorter hands-on time (1.1 vs. 5.3 min, P < 0.0001), and lower costs per single test than M-XM (1.44 vs. 2.70 USD). A-XM permitted annual savings of 46 million RPN, 15.1 months of daytime workers’ labor, and 47,042 USD compared with M-XM.ConclusionThis is the first attempt to implement A-XM using VISION Max. VISION Max A-XM appears to be a safe, practical, and reliable alternative for pre-transfusion workflow with the potential to improve quality and cost-effectiveness in the blood bank.

Digital Morphology Analyzer Sysmex DI-60 vs. Manual Counting for White Blood Cell Differentials in Leukopenic Samples: A Comparative Assessment of Risk and Turnaround Time

“…Automated analyzers have been introduced in hematology laboratories and blood bank laboratories; however, few studies have focused on laboratory efficiency in these laboratories with high manual workload [ 24 - 26 ]. These studies demonstrated the usefulness and applicability of FMEA in clinical laboratories and showed that automated methods are associated with lower RPNs than manual methods, which is in line with the present results.…”

Informing the State of Process Modeling and Automation of Blood Banking and Transfusion Services Through a Systematic Mapping Study

“… 26 The process of blood processing, including automatic activities such as group typing, subgroup typing, antibody screening, cross-matching, results entry, results reporting, and sending screening results from the laboratory to the blood bank, is yet to be fully automated. 18 , 19 , 26 , 28 , 29 , 32 , 34 , 35 , 39 The process of blood storage is commonly discussed in the literature, especially the automation of controlling the availability of blood units, checking the site of storage, and controlling the temperature of refrigerators. 26 , 35 The process of blood transfusion automation has also been discussed in the literature.…”

“…The process of blood processing, including automatic activities such as group typing, subgroup typing, antibody screening, cross-matching, results entry, results reporting, and sending screening results from the laboratory to the blood bank, is yet to be fully automated. 18 , 19 , 26 , 28 , 29 , 32 , 34 , 35 , 39 …”

An independent reader system that parallels critical steps of full automation capability for immunohematology testing

“…Based on user informed criteria for the development of ORTHO VISION® (VISION) and ORTHO VISION® Max Analyzers (Ortho Clinical Diagnostics, Raritan, NJ, US), fully automated systems for immunohematology testing, an opportunity to apply key attributes common to these instruments to a semi-automated solution was explored [4]. Using this concept ultimately provided a solution for those who wanted as many of the features of full automation in a semi-automated system.…”