Cardiothoracic operating room blood gas workflow performance improvement initiative

Area of Science:

• Cardiothoracic Surgery
• Laboratory Medicine
• Healthcare Informatics

Background:

• Specimen relabeling in operating rooms presents patient safety risks and delays critical blood gas results.
• Existing workflows for blood gas ordering and testing require optimization for efficiency and accuracy.

Purpose of the Study:

• To evaluate and streamline the blood gas ordering and testing workflow in a cardiothoracic operating room.
• To identify and implement performance improvement interventions to enhance process efficiency and patient safety.

Main Methods:

• A retrospective evaluation of blood gas specimen relabeling was conducted from August 2018 to December 2022.
• An electronic health record (EHR) intervention, an OpTime Epic Sidebar button, was implemented in January 2019 to streamline ordering.
• This intervention facilitated direct printing of laboratory barcode labels in the operating room, eliminating manual relabeling.

Main Results:

• The EHR intervention drastically improved the rate of appropriate specimen labeling, achieving sustained results.
• Post-intervention, over 95% of blood gas specimens arrived barcode labeled from March 2019 to January 2023.
• This contrasts sharply with less than 1% of specimens being appropriately labeled in the pre-intervention era.

Conclusions:

• Multidisciplinary collaboration is essential for addressing complex healthcare process issues.
• Performance improvement methodologies are crucial for developing effective and sustainable interventions.
• The implemented workflow successfully reduced specimen relabeling and improved the timeliness of blood gas result reporting.