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Quality Care and Mobility: Case 2

· Kim Tucker,

The Case of the Frustrated Phlebotomist

Phlebotomists – a valuable but rarely mentioned member of the healthcare team in who makes sure blood samples are drawn so that lab work can be done, results reviewed, and the proper orders can be implemented. Unfortunately, in many facilities, the advent of the electronic healthcare record (EHR) has not significantly impacted or improved their workflow.

In most acute care settings, they start their rounds very, very early in the morning. They start in the laboratory and then fan out across the facility, many times with a small cart of supplies and a stack of patient preprinted labels with patients’ identifying information and specimen collection information. If a patient needs 4 tubes of blood drawn, there will be 4 separate labels, one for each tube. As they go from patient to patient, they draw blood, peel off the corresponding label and place it on the tube. And they are supposed to date, time, and initial the label by hand. When they run out of labels, they go back to the laboratory, submit all the tubes for processing, grab a new set of labels and start the process over again. Seemingly a simple process, so where is the frustration?

Well, let’s say our phlebotomist is on the 4th floor drawing blood when two new orders appear in laboratory information system (LIS) from the EHR…darn, the phlebotomist has no way to know about the two new orders until the next round of specimen labels is picked up. This means the patient’s blood may not get drawn for another hour or two even though the phlebotomist was on the floor when the new order came through.

And what happens if the phlebotomist can’t get the blood drawn – how can they let someone know they haven’t drawn it and why? Additionally, there is now a set of unused specimen labels on the phlebotomist’s sheet of labels. This isn’t a good thing as it can lead to mislabeling, redraws, or missed labs.

PatientTouch Specimen Collection module can alleviate the frustration, potential for error, and patient harm by allowing for label printing at the patient side only after the blood has been collected. Phlebotomists are notified in real-time of new orders, decreasing the wait time between orders and results.

At one of the nation’s largest not-for-profit systems, implementing PatientTouch Specimen Collection in conjunction with Cerner lab and Allscripts EHR, allowed them to see an immediate 20% reduction in duplicate draws. They reported zero misidentified patients and specimens, and no unnecessary blood draws.

It’s these types of results that support mobility, interoperability, and technology that supports clinician workflow as the necessary next step in optimizing our EHR investments.

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