Turnaround time for red blood cell transfusion in the hospitalized patient: A single-center “Blood Ordering, Requisitioning, Blood Bank, Issue (of Blood), and Transfusion Delay” study

Abstract

Background and Aim:The turnaround time (TAT) for blood transfusion (BT) is an important quality indicator for the health-care institutions undertaking this procedure. There is no established national or international benchmark for this TAT due to the dearth of a published literature. We thus studied the TAT and the contributory procedures leading to delay in commencing a red blood cell transfusion in the hospitalized patient.Materials and Methods:Delay was captured for the blood order transcription, requisitioning and sampling by the nurse, blood bank (BB) processing, blood issue, and the transfusion commencement in the hospitalized patients. The study was done prospectively over a 1-year period and involved all the patient locations spread over six floors in a tertiary care accredited hospital.Results:A total of 2022 blood requests were analyzed during the study period. Most (73%) of the blood requests were marked as urgent by the treating unit. The average time from ordering to initiation of BT was 135 min in our study. BB processes (compatibility testing and issue) comprised approximately 47% of this delay (63 min), while rest of the delay happened in the processes (ordering 13 min, sample transport 34 min, and BT commencement 25 min) outside the BB (72 min).Conclusion:Majority of the delay for blood transfusion happens due to the processes outside blood bank premises. Understanding the steps where delay happens has the potential to reduce the turnaround time for lifesaving procedures such as blood transfusion in the hospitalized patients.

Sample collection for pre‐transfusion crossmatching: Benefits of using an electronic identification system

“…According to a study that analysed the test sample processing time of ER patients, the sample processing time from the sample order to the laboratory reception was ~40 min 16 . Another study reported 47 min for the sample processing time in ER 17 . It took ~40 min from the ER order to the sample reception, 16 whereas in our study, this time was 16.00 min during the day, and 19.83 min at night.…”

“…16 Another study reported 47 min for the sample processing time in ER. 17 It took ~40 min from the ER order to the sample reception, 16 whereas in our study, this time was 16.00 min during the day, and 19.83 min at night. Despite its effectiveness in preventing WBIT, the sample processing time with utilising the new workflow did not increase compared to the time that without utilising the new workflow.…”

Analysis of requests for reservation of blood concentrates in patients referred to urgent surgeries in a teaching hospital

“…The response time from the request chain to the transfusion was studied in an Indian tertiary hospital, where the median time between the request and its arrival at the blood bank was 47 min, the bag preparation time was 55 min, and the total time to transfusion was 135 min 22 . The authors considered this interval excessively long, mainly due to the delay in sending samples to the blood bank (34 min), shortages and messengers who completed the task, and the physical distance between sectors.…”

Untitled

“…Capacity building through training improves theatre efficiency and its output [12,14]. Surgical factors shown to increase TAT include complexity of surgeries leading to mental fatigue [15,16], ASA physical status [17], poor patient preparation [18,19] and unavailability of blood during surgery [20][21][22].…”