Document resource
Aims and Objectives The aim was to enable the initiation of blood borne virus (BBV) screening for all patients receiving phlebotomy within one ED, streamlining requesting and processing of samples. This project ties closely with green ED initiatives, the opt-out BBV initiative to eliminate new HIV and hepatitis B and C infections by 2030, while also improving the efficiency of phlebotomy processing and IT within the department. This project is a good example of the common challenges across departments and simple solutions for significant improvement in departmental streamlining.Method and Design Using feedback from staff within the ED and acute medical team with information from the BBV steering group, driver diagrams demonstrated that inefficiencies in phlebotomy processing contributed to inability to initiate BBV screening. Fishbone diagrams demonstrated inefficiencies in phlebotomy were due to printing inefficiencies for requesting sample testing within the ED. Staff were requesting excess tests on paper forms rather than using pre-sets that would be processed rapidly. The IT team changed the printing system, removing significant redundancy, then we added the BBV screening to the order sets, and the number of screenings completed would correlate with the number of bundles being used.Results and Conclusion The new printers improved efficiency within ordering, allowing allowing BBV screening to be initiated within 2 weeks. After 1 month, 77% of all samples included BBV screening (41310 samples). ED recyclable waste reduced by 30% due to reduced redundancies. INR testing reduced by over 30% as they were not included in pre-sets. Reporting times sped up significantly, and after a second set of data was collected by questionnaire for the ED and acute medical team regarding ordering and printing for phlebotomy, there was a significant improvement in work satisfaction and efficiency, with an estimated time saving of over 30 minutes per clinician per day.