Improved efficiency in providing blood to surgical patients using a novel approach to preadmission testing

Expansion of the preadmission process for same-day-admit (SDA) surgery pati ents through our Admissions Evaluation Center has provided an efficient and convenient means for complete patient evaluation up to 30 days in advance of surgery. Traditionally, collection of blood samples for the pretransfusi on testing that is necessary to select compatible blood for transfusion occ urs within 72 hours of admission, consistent with standards to ensure detec tion of red blood cell (RBC) alloantibodies formed as a result of recent tr ansfusion or pregnancy. As a result, samples for many SDA patients were sub mitted Stat the morning of surgery, resulting in an unwieldy amount of test ing and delay in blood availability. To address this problem, the time inte rval for collection of patient blood samples for pretransfusion testing was extended to 30 days prior to surgery. To ensure safety, this change requir ed documentation of patient transfusion and pregnancy history at 2 specific timepoints. Input from a multidisciplinary team was vital to assess the pr ocess of blood ordering and administration and to determine the best means to accomplish these steps. Implementation of the new process resulted in a decreased number of emergent requests for compatibility testing, decreased delays in blood delivery, and elimination of canceled surgery due to cases with unexpected RBC antibodies.