A problem to solve…
Walsall Hospitals NHS Trust recently moved over to a new Laboratory Information Management System (LIMS) but the transition led to the loss of their old Phlebotomy Management Software. In seeking a solution to resolve this shortfall Trust IT and Pathology managers, Robert Lee and Stephen Harris, decided to address the issue by utilising eBooking and label printing functionality available within their ICE Desktop Requesting order communications software.
A process agreed…
Having installed ICE Desktop Requesting over past months the management team realised that additional features within the browser based software, such as the new release of e-Bookings service management, could be deployed to provide a workflow process for phlebotomy management. It was agreed that the following process would prevail:
- requests are booked into ICE Desktop e-Bookings
- when an order is placed a message is sent to the Trust’s results reporting portal showing clinicians there is an outstanding request for a patient to be bled on the next ward round
- phlebotomy management lists for each ward round are produced together with the required number of barcode labels for each request, and this information is made available to the phlebotomists
- phlebotomists proceed to bleed their patients on the ward round and acknowledge doing so within the ICE sample collection module
- an acknowledgment in ICE updates the request from ‘requested’ to ‘specimen collected’ and the order message is sent onto the LIMS.
- once receipted by the LIMS, the LIMS outputs a message to the results reporting portal to indicate that the sample is now in the Laboratory and is being processed
Some operational benefits…
In his assessment of the system Stephen Harris, Pathology Computer Manager at the Trust, has identified a number of operational advantages “ICE Desktop has been configured to assign the laboratory sample number to the sample when the request is made. As such, when the sample labels are produced they contain the laboratory sample number barcode. Hence, when the samples are returned to the laboratory, there is no requirement to re-label them. The order is imported into the LIMS and the samples sent for processing. Not only does this save a great deal of time, but it also reduces greatly the risk of mislabelling – the phlebotomy samples are only labelled directly at a patient’s bedside”.
He went on to state that “the phlebotomy summary sheet has all the information the phlebotomist requires to locate and bleed the patient - demographics, test information and blood tube information and, due to the real time PAS ADT feed provided to ICE, the summary sheet has the ward location as well as the room/bay information, which allows faster location of a patient”.
The way in which the labels workflow has been designed ensures that barcode labels produced contain not only the laboratory number, but a patient’s demographics and test information too. Additionally provided is information regarding to which tube a label should be applied so aiding to ensure the correct samples are received at the laboratory.
And the future….
The Pathology Department now has plans to expand on the use of ICE Desktop e-Booking functionality by using it to manage both Outpatients and GP phlebotomy needs. “We plan to book patients in to published ‘clinic’ slots thereby providing each patient with a timed appointment. It is anticipated this approach will help to solve issues around clinic overbooking and, by using the electronic appointments system in ICE will also help with monitoring our 18 weeks to treatment target”.
As a web based application ICE has also provided additional benefits. Walsall has a community wide network and the application can easily be accessed remotely to mange external clinics such as anticoagulant and diabetic clinics.