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Advantages of type and screen policy: Perspective from a developing country!
Geet Aggarwal1, Aseem K Tiwari1, Dinesh Arora1
1Department of Transfusion Medicine, Medanta - The Medicity, Gurgaon, Haryana, India.
Asian Journal of Transfusion Science
|March 23, 2018
Summary
Implementing an immediate-spin (IS) crossmatch policy significantly reduced crossmatch-to-transfusion ratios and blood issue times. This change also decreased red blood cell (RBC) outdating, saving staff time and hospital funds.
Area of Science:
- Transfusion Medicine
- Clinical Pathology
- Hospital Administration
Background:
- The study center transitioned from conventional type and screen (TS) with anti-human globulin (AHG) crossmatch (Policy A) to TS with immediate-spin (IS) crossmatch (Policy B).
- Red blood cell (RBC) units were issued post-compatible IS crossmatch, replacing AHG crossmatch.
Purpose of the Study:
- To compare the impact of Policy A versus Policy B on key performance indicators.
- Evaluate changes in crossmatch-to-transfusion (C/T) ratio, RBC issue turnaround time (TAT), RBC outdating, man-hours, and cost savings.
Main Methods:
- A comparative, prospective study was conducted in a tertiary hospital's blood bank in Northern India.
- Policy B implementation in January 2014, with retrospective data from Policy A (previous year) analyzed.
- Data sourced from the hospital information system for comparison.
Main Results:
- A significant reduction in C/T ratio (1.94 to 1.01) and RBC issue TAT (79 to 65 minutes) was observed with Policy B.
- Expiry due to outdating decreased from 37 units to zero.
- Man-hours consumption reduced by 16%, and monetary savings reached 33%.
Conclusions:
- The 'TS with IS crossmatch' policy offers substantial benefits to all stakeholders, including blood bank staff, clinicians, patients, and hospital management.
- This policy change streamlines pretransfusion testing, leading to improved efficiency and cost-effectiveness.
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