The National Blood Authority (NBA) is currently working on a range of activities to support hospital and pathology services to fully implement the National Safety and Quality Standard for Blood and Blood Products. One of the ways in which this is being achieved is to identify areas of best practice already in existence across the country, record and document these practices for others to view and further develop in their own workplace. Relevant techniques, tools and approaches undertaken by various providers will be published below as they become available so other centres across Australia can adopt and modify practices to suit their own conditions. It is important to note that these case studies are provided as one example of an approach that worked for the individual facility. Where centres would like to adapt practices for local use, they should consider all implications and risks that may be specific to their own conditions prior to implementation.
Small volume tubes at Flinders Medical Centre, SA
Hospital acquired anaemia or iatrogenic anaemia is anaemia that results from blood loss due to repeated blood sample collection (phlebotomy), of hospitalised patients for the purpose of diagnostic testing. This case study illustrates the implementation of the introduction of small volume sample tubes at the Flinders Medical Centre intensive care unit, which significantly reduced iatrogenic blood loss due to diagnostic testing without adversely affecting the laboratory workflow.
Visit the Use of small volume tubes to reduce blood loss Case Study to see how this project was implemented.
Pathology Queensland comprises a hierarchical, networked system of 33 laboratories, providing pathology services to all Queensland Health public hospitals. This case study looks at the Pathology Queensland laboratories in the Royal Brisbane & Women’s, Redcliffe, Toowoomba and Townsville hospitals and illustrates some of the processes they have in place for blood management to minimise blood wastage, particularly around transfer arrangements and stock movement.
Visit Pathology Queensland Case Study for more information on these processes and the outcomes they deliver.
Hunter Area Pathology Service (HAPS), NSW
The Hunter Area Pathology Service operating at the John Hunter Hospital laboratory has one of the lowest wastage rates for blood and blood products in Australia. It is their close management of inventory, quick release of product upon request, a team of involved haematologists and close management of age of product inventory that enables the team at John Hunter Hospital to consistently achieve these low wastage rates as well as be forerunners in the field of inventory management.
Visit Hunter Area Pathology Service Case Study to see how HAPS is delivering better services to their community.
SAN Pathology, NSW
San Pathology at Sydney Adventist Hospital has one of the lowest blood and blood product wastage rates of the Australian private health sector. San Pathology's practices of limiting cross matches to 24 hours, a focus on individual responsibility, close haematology support, ongoing training and regular audits allow them to achieve and maintain an excellent discard rate. In addition it is clear that their culture and attitude towards treating blood as a precious resource has made a clear impact on the responsibility accepted by staff.
Visit SAN Pathology Case Study to see how the SAN is delivering better services to their community.
The Country Health South Australia Local Health Network (CHSA) BloodMove Project is a collaborative program to facilitate best practice in blood management throughout regional South Australia. BloodMove oversees 60 regional hospitals that are supplied with blood and blood products by both regional and metropolitan transfusion services. Since its commencement, BloodMove has sustained and further improved upon reduction of avoidable blood wastage in CHSA - from 15% in July 2007 to less than 1% in January 2013.
Visit BloodMove Project Case Study to see how this project has made substantial changes in South Australia.
BloodMove Platelets, SA
The BloodMove Platelets project aimed to reduce platelet wastage rates due to expiry. The project involves a collaborative platelet inventory concept comprising of moving Day 4 platelet blood stocks from low usage sites to high usage sites and then sharing a common multi-site near expiry Day 5 platelet inventory. With this collaboration and minor inventory level and dispatch practices changes, platelet wastage rates have reduced from highs of up 21% down to 6%.
Visit BloodMove Platelets Case Study to see how this project has made substantial changes in South Australia.
Burnside War Memorial Hospital, SA
Burnside War Memorial Hospital in South Australia recently reviewed its perioperative red blood cell ordering practices. The resulting implemented changes have allowed this not-for-profit community-based hospital to successfully reduce blood bag handling, improve patient safety and free up nurses for patient care. In addition, Burnside Hospital is well on its way to meeting Standard 7 of the National Safety and Quality Health Service Standards.
Visit Burnside War Memorial Hospital Case Study to see how this project was implemented.
The Royal Children's Hospital Melbourne Extended Life Plasma Protocol
The Royal Children’s Hospital, Melbourne introduced the use of Extended Life Plasma following extensive in-house safety and efficacy testing. As a result of implementing an ELP protocol, the laboratory at the Royal Children’s Hospital can not only provide thawed plasma in a timely manner but has also significantly reduced the wastage of unused thawed fresh frozen plasma across all clinical areas.
Visit The Royal Children’s Hospital Extended Life Plasma Case Study to see how this protocol was implemented.
Preoperative anaemia identification, assessment and management case study
The preoperative anaemia identification, assessment and management case study is intended to inform healthcare practitioners, health educators, health service managers and policy makers about preoperative anaemia screening. This resource provides a wealth of ideas and links to help hospitals use clinical practice improvement methods to implement an anaemia screening clinic based on evidence-based recommendations in the Patient Blood Management Guidelines: Module 2 – Perioperative.
Visit the Preoperative Anaemia Identification, Assessment and Management Case Study to see how this project was implemented.
Point of Care Coagulation Testing Case Study The Prince Charles Hospital Brisbane
This case study illustrates efforts undertaken by clinical staff at The Prince Charles Hospital in detecting, managing and monitoring critical bleeding in cardiac surgery patients through the use of Point of Care Coagulation Testing.
Visit the Point of Care Coagulation Testing Case Study The Prince Charles Hospital Brisbane to see how this project was implemented.
Liverpool Hospital, NSW
Prior to December 2013 Liverpool Hospital used a paper based sign-out register for logging blood products in and out of their operating theatre fridge. This register was often not completed or inaccurate. As a result staff could not be confident that unused red blood cells had been returned to the fridge within a 30 minute window thereby ensuring it was safe to reissue. There was also the additional risk that blood removed from the operating theatre fridge for transfusion could go to the wrong patient. These risks were seen as unacceptable and in an effort to reduce these risks, the hospital transfusion service implemented the use of Radio Frequency Identification (RFID) tags to track the intra-hospital movement of their blood and blood products with the aim of improving patient safety.
Visit the Liverpool Hospital Case Study to see how this project was implemented
Further Case Studies
The NBA is developing case studies on an ongoing basis. If you have a suggestion for either a general topic, or a specific example for a case study, please contact the Health Provider Engagement team at the National Blood Authority email support [at] blood.gov.au (subject: Case%20Studies) or by telephone 13 000 BLOOD (13 000 25663).