Today we’ll be discussing ways of reducing errors through automated testing.
Accurate pre-transfusion ABO and RH blood group identification and antibody screens are essential for transfusion safety. Human errors during this testing may lead to adverse clinical events.
Despite the recent development of automated platforms to limit human errors, adoption of this technology has been slow. Many transfusion laboratories still use manual testing methods.
Recently, researchers demonstrated that automated pre-transfusion blood grouping and antibody screening methods are associated with substantially fewer errors than manual testing methods.
Using failure modes and effects analysis, a risk assessment tool often used in operations research, the group quantitatively assessed the error potentials for alternative manual and automated pre-transfusion testing methods.
The research team collaborated with managers and technical personnel from different transfusion service laboratories which were using the evaluated testing procedures.
The manual blood grouping and screening procedures that were assessed featured combinations of three assays: manual large-well titration plates (also known as tiles), traditional test tubes, and manual column agglutination technology.
The automated testing methods were based on using the ID-Gel Station, ProVue, AutoVue Innova, or Galileo platforms.
The study, published as a supplement in the journal Transfusion, identified the number of process steps and defect opportunities for each method. The risk of error was assessed at each of these steps.
By incorporating the severity of each potential failure, the frequency of failure occurrence, and the likelihood of failure detection, a risk priority number was calculated for each of the testing procedures evaluated.
The authors found that while manual methods were associated with 22 to 39 process steps, automated methods involved only 6 to 8 steps.
Further, they noted that automated methods decreased defect opportunities by 90 to 98% and had lower risk priority numbers than manual alternatives.
Since the automated methods required only 3 high-level process steps, human interaction throughout each procedure was minimized. Consequently, the authors conclude that automated methods lead to less inherent error than manual methods.
Dr. Paul Ness, the Director of Transfusion Medicine at Johns Hopkins Hospital, Professor of Pathology at Johns Hopkins University, and the Editor of the journal Transfusion. He was not associated with the study, but he had this to say:
“Many large transfusion services have adopted automated testing to reduce labor costs and manage shortages of skilled medical technologists. It is now clear that automated methods can also reduce turnaround times with the potential to reduce laboratory errors, assisting in our goal of zero tolerance for error. Hopefully, further studies can provide empirical data to confirm that automated testing does reduce testing errors.”
That’s it for this edition of Transfusion News. Thanks for joining us. We’ll be back on September 15th with more of latest developments in the field of transfusion medicine. In the meantime, you can always keep up to date by visiting transfusionnews.com.
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