That was the sentiment expressed by many when the new My+® blood centre application was introduced at the beginning of March. The old Vertti blood centre programme was shut down at 8 am and the new system was in place by the afternoon. The big day was preceded by a great deal of planning and training and the work did not stop with the successful implementation.
We worked around the clock to solve some issues that we had not noticed beforehand. But, on the whole, we felt very positive about it, says project manager and information system designer Johanna Forstén from HUSLAB.
Everyone stepped up fantastically. Even though the days were long, it was nice to work together towards a common goal for this project, says Tuulia Palukka, specialist at the Meilahti blood centre.
The My+® blood centre application was implemented at the same time in all eight of HUSLAB’s blood centres. Approximately 30 percent of Finland’s blood products go through them. The new information system significantly changed the entire blood transfusion process at HUSLAB and on the wards. The biggest change was the adoption of the “type and screen” practice and the related compatibility test. The practice applies to around 90 percent of patients. This leaves just those patients who have red blood cell antibodies and some stem cell and organ transplant patients. Previously, HUSLAB blood centres used to do a physical, serological compatibility test on every blood product that was going to a patient. Now, the compatibility test can usually be done electronically, which speeds up blood transfusions and frees up the laboratory nurses’ working time for other tasks.
The possibility of human errors also decreases, when the system checks that the patient receives blood products specifically suitable for him or her, laboratory nurse Liisa Mäki adds.
When blood products are ordered for a patient, the nurse takes a sample from the patient and the blood centre does a blood group analysis and an extensive red blood cell antibody screen on it. If no antibodies are found and the patient fulfils the remaining criteria, the information system does an electronic compatibility test by comparing the blood sample’s information with the blood product’s information. The compatibility test is valid for five days, during which the patient can be given more blood quite quickly.
Previously, if the patient began to bleed in the operating room, it would take about half an hour to crossmatch more red blood cell products for the patient. In comparison, the electronic compatibility test only takes a few minutes, bioanalyst Nessa Heidar Mehrabipour explains.
However, in emergency situations such as accidents, emergency blood products that have not been crossmatched still have to be used. But if compatibility tests have been completed and the patient does not have antibodies, an emergency blood transfusion can be as safe as a planned blood transfusion.
Management of blood storage also changed as a result of implementation of the new information system.
Clinical expert Ulla Peltola explains that blood products were not entered in the information system before. Now, it is mandatory in order for the system to have something to compare against the patient’s information. When all blood products are registered in the information system, the inventory can be managed electronically.
If we need some special kind of product, the information system tells us whether we have it in store or not. Laboratory nurses no longer have to root around in the fridges to find a compatible product, Peltola adds.
Previously, storage held a large number of blood products reserved for specific patients. Now the products we have in storage are available to all patients and the bags are only marked with initials when they are sent out to the wards.
We can use the blood products in chronological order, which means that they are fresher when sent to the patients. Large quantities of bags are no longer lying around in storage, waiting for the time when a specific patient needs them, Liisa Mäki describes.
How about the information system and its user interface, are users happy?
The application is good and precisely what we expected, bioanalyst Nessa Heidar Mehrabipour sums up their experiences of the application.
Specialist Tuulia Palukka agrees.
The system is super easy to use: you can find the functions where you would logically expect them to be. The main challenge has been around our own practices, that is where each bit of information should be entered, she explains.
The new information system changes work practices both at blood centres and in care units. They have to consider if it is sensible to make blood orders just in case, for example, since that means a great deal of compatibility tests for the blood centres. According to project manager Johanna Forstén, at lot of work has been done at HUSLAB to make all processes more efficient.
We are still learning and it will take some time before we settle into a new routine. Only then will we be able to see more clearly the benefits that the new information system brings, she explains.