Pathology Queensland Case Study

Pathology Queensland provides pathology services to all Queensland Health public hospitals. Pathology Queensland comprises a hierarchical, networked system of 33 laboratories. These laboratories consist of district laboratories in rural hospitals, group laboratories in large regional hospitals and unit base laboratories providing tertiary referral services in the metropolitan teaching hospitals.

Pathology Queensland has approximately 1,500 consultant pathologists, scientists, technicians, operational and administrative staff.

This case study looks at the Pathology Queensland laboratories in the following hospitals and highlights some of the processes they have in place to minimise blood wastage, particularly with regards to transfer arrangements and stock movement:

Pathology Queensland laboratories prepare emergency issue ‘Medevac packs’ for their site and supply O negative units to  40 non-laboratory sites such as the critical care aeromedical retrieval service ‘CareFlight’.  This requires management of over 200 units of O negative red blood cells (RBCs).

Laboratory workload involved in supplying Medevac units for laboratory and non-laboratory sites is considerable, especially impacting on smaller laboratories who provide units to multiple ‘non-laboratory’ sites. Keeping a stock of Medevac units at a non-laboratory site creates a significant workload and responsibility for the nursing and clinical staff who ensure refrigeration documentation is complete and units are stored and transported correctly.

Transfer arrangements

  • In order to minimise wastage, all large laboratories receive ‘short expiry’ units from district laboratories, and non-laboratory sites return O negative units to the supplying laboratory.  Ideally RBC units are rotated with at least 10 days to expiry.
  • For remote sites that do not have laboratory staff on site, members of the nursing staff receive training in storage and transport of blood and blood products.
  • All components transferred between Pathology Queensland facilities are accompanied by temperature indicators (Safe-T-Vue) and documentation which includes transport information for the receiving site. The units are checked on arrival to ensure they are suitable for transfusion before accepting into inventory/placing in the remote blood fridge.
  • Pathology Queensland has revalidated the Blood Service shipper for Queensland ambient conditions. All Queensland hub-and-spoke sites use the same procedures and material for inter-facility transfers.
  • Using the Blood Service shippers for inter-facility transfers helps address any environmental concerns, as shippers in remote sites are transported to the main hub facilities and returned to the Blood Service.
  • Transport costs for blood and blood products are an ongoing issue.

Acknowledgements

The National Blood Authority extends its appreciation to the staff of the Queensland Pathology laboratories at the Royal Brisbane and Women’s, Redcliffe, Toowoomba and Townsville hospitals for their support, contributions and involvement in the development of this case study. In particular a special thank you to:

  • Dr John Rowell: Director Haemophilia Centre, RBWH
  • Sue Williams: Senior Scientist, Pathology Queensland – RBWH
  • Nick McKeough: Transfusion Nurse, Pathology Queensland – RBWH
  • Tamie Hall: Scientist, Pathology Queensland – RBWH
  • Phillip Winwood: Scientist,  Pathology Queensland  – Redcliffe Hospital
  • Michael Burrett: Senior Scientist, Pathology Queensland  – Toowoomba Hospital
  • Michael Wilhelm:  Supervisor, Transfusion Medicine Department, Pathology Queensland – Townsville Hospital
  • Janelle Toombes: Clinical Nurse Consultant, Haemovigilance, Townsville Hospital