Informatics Improves Management of Blood Services

Clinical Informatics promotes the understanding, integration, and application of information technology in health care settings. Clinical informaticians transform health care by analyzing, designing, implementing, and evaluating information and communication systems that enhance individual and population health outcomes, improve patient care, and strengthen the clinician-patient relationship.

In the fall of 2014, the Pathology Informatics group at Nova Scotia Health Authority’s Central Zone (Halifax area, Eastern Shore and West Hants) recognized an opportunity to improve the process of managing the red blood cell (RBC) product inventory.

A few years ago, a routine review indicated an increase in RBC waste, the most commonly transfused blood component in the hospital system, as a result of expiration. The review also revealed varying blood ordering practices among technologists that were both complex and time consuming.

To address these challenges, the Pathology Informatics Group collaborated with Blood Transfusion Services to develop an automated algorithm that simplified and standardized the RBC ordering process. Launched in June 2015, the tool combines historical data and predicts future usage to determine RBC inventory numbers, which supports better management of inventory by “right sizing” it and making it more responsive to meet demand. This highlights the creativity of the Pathology Informatics Group to utilize the data in the system to better leverage our resources. We didn’t have to buy anything; we just had to find a way to utilize the data more effectively, says Dr. Calvino Cheng, Hematopathologist and the provincial Health Authority’s Chief Medical Information Officer.

Through the adoption of the new inventory management tool and processes, the Central Zone is now able to more quantitatively order the amount of RBC units required during the weekdays and especially into weekends and holidays than was possible in the past. There has been a reduction in the handling time of RBC inventory by approximately 2 days, and this could benefit patient care as RBCs aren’t held in inventory as long and are fresher for patients.

Through the introduction of the new algorithm, and better management of RBC inventory, the number of RBC units discarded due to expiration has been reduced. Each unit saved from wastage saves approximately $450 in real costs. During the first 12 months of the algorithm’s implementation, the health system had saved $58,950. In comparing the full 23 month period since the algorithm was implemented to the same 23 month period two years prior, approximately 407 units were saved from being outdated, resulting in a $183,150 savings to the health system.

Prior to the development of the new tool, there was a significant amount of complexity and manual work required to calculate and account for inventories in different areas in the laboratory, hospital and overall health system. Typically, technologists were spending from 30- 45 minutes, 1-2 times daily ordering RBC inventory. With the implementation of the new tool, daily ordering times have been reduced to an average of 10 minutes, with some technologists completing their orders in seconds. Not only has this tool generated measureable savings due to the reduction of RBC waste, it has also provided qualitative savings by enabling technologists to use their time more effectively.

The new inventory tool is currently being used at Halifax Infirmary, Victoria General Hospital as well as Dartmouth General and Hants Community Hospitals and there are plans to expand its use across the Health Authority in the future. This is just one example of how clinical data can be used for analytics to support and manage health care resources. There are many more examples of the positive impact that clinical informatics is contributing to both the bottom line and the enhancement of the delivery of patient care within Nova Scotia Health Authority. For more information, please visit – http://imit.nshealth.ca/news-events/archive.

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