Background/Case Studies: The blood center (BC) receives electronic service orders to provide antibody identification (ABID) results to hospitals within its service area. With the shortage of licensed Immunohematologists, the local Immunohematology Reference Laboratory (IRL) experienced critical staffing levels in comparison to workload demand. It became a challenge to meet the expected turnaround time (TAT) of the requesting hospitals. The BC formulated a process to outsource workload to surrounding labs within the organization to meet the demands of the customers. This study showcases the evaluation of outsourcing orders, the amount of help received from supporting labs, and the impact on overall TAT.
Study
Design/Methods: The BC transportation department provided the current movement schedule going to each of the supporting labs. Samples were sent with those scheduled movements to avoid increase of transportation cost. An automated reminder instructing to evaluate current workload was sent to the local IRL an hour before each scheduled departure time. If there were less than two ABID orders per tech, then samples remained in-house. If there were greater than two ABID orders per tech, then supporting labs were contacted. The lab receiving the order would ensure the appropriate amount of staffing was available to perform the testing and dispense the blood products in a timely manner. Requests from March 1, 2022 (implementation date) through February 28, 2023 were evaluated and filtered to list all orders sent to the supporting labs. A spreadsheet was created to track and compare the average TAT of each lab from the time of order submission to the time of order completion. The average TAT 12 months before and after workload triage implementation was compared.
Results/Findings: A total of 1832 ABID orders were received in the local IRL during the evaluation period. Out of those orders, 571/1832 (31%) were sent to supporting labs. The average TAT for all labs before the change was 16 hours. Table 1 summarizes the average TAT per lab after the change. The overall TAT for labs increased to 17 hours (6%) since the workload triage implementation. Conclusions: Despite staffing challenges and slight increase of overall TAT, client workload was met through rigorous case analysis and coordinated logistics between labs within the same geographic area and organization. Prompt communication from the BC to the receiving lab was essential in ensuring the workload could be transferred and completed within expected TAT. Electronic advances, such as final report uploads, further enhanced the process and provided additional benefits to the client base.
Importance of research: Due to the shortage of licensed Immunohematologists, hospital labs and IRL experienced extremely low staffing levels. This increased the demand of the IRL support to the hospitals. The blood center had to be innovative and find a way to support the understaffed IRL to assist with the completion of antibody identification orders without delaying patient care.
