(P-MG-2) Identifying Best Practices Within a Large Hospital System

Background/Case Studies: Hospital systems are constantly growing by adding hospitals or combining systems. The question is how do these different entities share information and work on best practice? Often within the laboratory there are different testing sections that have similar concerns or processes. Our institution combined a 26 hospital system in the Midwest (MW) with a 46 hospital system in the Southeast (SE). Both locations had developed procedures, and MW had already moved to standardization for most processes. The SE system was still in the process of moving to one computer platform and each of the 4 regions had separate processes and procedures.

Study

Design/Methods: The MW region had previously gone through a merger of 2 states so had what was referred to as a Technical Advisory Team (TATm). The TATm for the Transfusion Service (TS) had been meeting monthly for over 12 years to work on process and procedure changes, automation vendor recommendations, regulatory change review and computer system upgrades. This has led to sharing of ideas and attempts to work toward “Best Practice.” With the combination of the 2 large systems to become one the TATm was moved to an Enterprise Technical Advisory Team (eTAT). The Enterprise is extremely diverse with sites ranging in size from 10 beds in a rural setting to a large university based medical center of close to 900 beds.

Results/Findings: Monthly eTAT meetings have led to the sharing of ideas and processes that different regions have struggled with to improve. Members of the eTAT include TS leaders from all regions as well as several TS physicians and administrative leadership. Topics like bedside blood product scanning, nursing audit process, computer system enhancements for both the Hospital Information System (HIS)and the TS specific computer system, mass casualty event procedures and regulatory changes have led to updates and improvements for the different regions. Standardization in irradiation indications as well as moving all sites to consider leukocyte reduced cellular blood products to be “CMV Safe” are being implemented with the use of plans and presentations previously used from other regions. Multiple initiatives are helping to make the blood transfusion process safer, more efficient and less costly.

Conclusions: Being part of a large system can be overwhelming and frustrating at times. Nothing in a large system moves quickly but having examples where barriers have been removed and regions have been successful has helped everyone on the team. Using process improvement changes, procedures and presentation information that has been successful at other locations saves time and effort. It is always helpful not to have to reinvent the wheel if one of the other sites has already figured out an answer to someone else's question.