8/9/2019 Blood Bak Process Map

1/1

Founded on the past - fit for the future

Blood banking redesignScottish National Blood Transfusion Service Blood Banking Laboratory Redesign Group

made up of representatives from all five regional centres, including senior scientists and staff fromQuality Assurance and Regulatory Compliance, as well as training.

Benefits to date include:

Improved customer satisfaction

Increased staff satisfaction

Reduction in wastage/non value add activity

Improved efficiency facilitating the capacity to take on new projects/initiatives

Fit for the future organisation Improvement in regulatory compliance

Reduction in work for other internal departments who support the clinical service i.e. Quality and Procurement

Reduction in SOPs/paperwork

Lean manufacturing

Ultimately the impact of this redesign will be felt across the whole organisation resulting in SNBTS being more efficient, effective and agile an organisationfit for the future that will continue to meet the transfusion needs of patients in Scotland.

Conclusions

The aim of the Blood Banking Redesign Project is to address historical regional differences within the Blood Banking process.

Within Scottish National Blood Transfusion Service (SNBTS) Blood Banking, 80% of activity is providing blood and blood products for transfusion to patientsrequiring it as part of their management of care. These products may be elective or urgent, and are usually life enhancing or life saving.

Within the complex model of regional silos, work was duplicated and processes customised locally. Activity recording varied by site, the ability to meetunplanned demand was limited and there was little linkage between workforce plans and operational activity.

It was essential to review the existing processes with the objective of redesigning and standardising these processes to provide a more efficient, effective,consistent and agile service.

Aim

Phase 1 of the project went live in January 2014. The success of Phase 1 can be

measured by its achievements:

A national process has been agreed

The number of SOPs for Phase 1 has reduced from 25 to three

All forms, letters and documentation have been agreed and standardised

Training and competency have been nationalised

Equipment has been reviewed to allow forward planning and future managed

service contracts to be delivered

The process map will be used to inform the workforce plan for blood banking

In addition, process mapping has been completed in 23 areas of Patient Services,

including Histocompatibility, Immunogenetics and Immunology, Blood Banking,Apheresis and Cord Blood. Work is ongoing to review and standardise processes

across the service. Phase 2 has now commenced and it is envisaged that this it willgo live in late summer, with Phase 3 hopefully following in December.

Outcomes/results

Phase 1 process mapSNBTS Clinical Directorate

1.00- Blood Banking Process Group and Save /Crossmatch (excludesante-natal)

Receive&time/date

sample

Checksampleasperpolicy

Register

sample

SampleOK?

Checklabel

against pt detailsonform& sample

Closeall screens

andensurelineclearance

Centrifugeaspertesting

spec

Preparesampleforanalyser

Loadanalyser

andlogoffuser

P-2

N

Time EquipmentMaterialsUsedProcessStepSOPs/FormsStaff Location

Page 1

MLARequest form

SampleDate/timestamp

Traceline(GLA)

Telepath(GLA)

Receptiondesk

MLA

MLA

MLA

MLA

MLA

MLA

MLA

BMS

BMS

Labelsample&form(2labels*)

BMS

Reject formReject sample

MLA

Telephone

Traceline

Traceline(GLA)

Telepath(GLA)

Racks

Trays

LaboratoryCentrifugeBalancetubes

Printer

Tracelineinterface

Printer

BioradIH1000

OrthoInnova

Cassettes/ gelcards

Saline

Distilledwater

Redcell diluent

Reagent redcells

Laboratory

Laboratory

Laboratory

Laboratory

15mins 1

hour

2mins

Labels(print 2-reconcile)

1min

5mins

5mins

Patient manual003

Barcodescanners

NATP Clin11

NATS CLS 041

Tracelinemanual1&2

Y

Loginandsetupanalyser

Checksample,barcode, form.

Prioritise

Decide

urgency

Manual/auto

Followstandard

process, but testsdonemanually

Followstandardprocess, but move

sampletocrossmatchearly

30-45mins

Manual Auto

45mins to

1hour

Laboratory

Laboratory

Laboratory

Laboratory

Laboratory

Laboratory

Segment openers/ scissors

Valid

sample?

Majorhaemorrhage

< 15mins

Electronicissue,

GroupspecificSalinespin (page2)

Issueemergency

O neg

Yes No

P-2

1.01

1.02

1.03

1.0x Crossreferencetos ub-process

1.04

Receiptandidentification

Registratio

n

Initialtesting

Bucket caps

Segments(GLA)

NAT GEN032

NATS CLS 037

PHASE2

Scope1.00 - Blood Banking Scope

-1.00BloodbankingGroup& Save+

CompatibilityTesting

- 2.00-Bloodbanking

Ante-natal

-3.00RedCell

Investigation

-4.00Stock

Management

-5.00Stemcell

-6.00-Component issue

(inc H&I?)

-7.00Coldchain

Samplereceiptand

identification

Patientregistration

InitialtestingFurthertesting(asneeded)

Issueandtransport of

unitsValidation

Returnofunusedunits&

traceability

To carry out this review, the Blood Bank Laboratory Redesign (BBLR) group

was formed in January 2013 and included members of staff with knowledge

of the processes in each region.

Five regional blood-banking process maps were evaluated

A single national map based on best practice from all sites was

developed

Processes were leaned wherever possible

Non value added tasks and paperwork were removed

At the same time, the project team reviewed National Guidelines

(British Committee for Standards in Haematology, Red book,

European Directives, etc) to ensure that any recommendations

were incorporated into the new processes. The national process

map took three months to develop and included the development

of standard national forms and standard operating procedures

(SOPs).

The process itself is complex, therefore, a systematic and

phased approach was adopted to deliver changes in a timely

manner. Three phases were agreed.

Using a Plan, Do, Study, Act cycle of improvement, a national

Change Control was submitted and the new process was

piloted for a month. At the end of the month there was a

lessons learned and a process review, at which point alterationsto SOPs, forms, etc were carried out, and a national training

programme organised.

Methods

ACT

STUDY D

O

PLAN

Decideimplement-aton plan,

pilot andimplement

Define theobjectve/

datarequirement

Carry outthe plan,

begin toanalyse waysof working

Analyse thedata and

decide whatphases are

needed

For more information, contact Susan Buchanan, Operations Manager, Patient Services: 0141 357 7700, sbuchanan@nhs.net