Background/Case Studies: Transfusion services must always remain operational, even during unscheduled events like power outages, lab floods, or cybersecurity attacks (CSA). Each facility has a contingency plan to maintain operations without a Laboratory Information System (LIS), often relying on a paper backup system. This was a retrospective review of how our facility managed to continue operations without an LIS and still ensure uninterrupted patient care during a CSA.
Study
Design/Methods: This was a retrospective review of an 11-day CSA, focusing on how blood bank operations were maintained during the extended LIS shutdown. A review of which tests would continue testing on the automated platforms and the percentage performed manually, was included. Turnaround times (TAT) were examined, and the process for implementing results post-CSA were reviewed.
Results/Findings: It was confirmed that a CSA had occurred on Sept. 2024 but had not infiltrated through the two Echo Lumena (Werfen, Norcross, GA) in use. During the CSA, Transfusion Services was able to operate the instruments off-line and print patient reports. Automated assays performed and maintained during the CSA included: ABO/Rh, Antibody Detection, ABO/Rh Retypes, CORD ABO/Rh, DAT-IgG and antibody Identification. These results were then hand carried to each patient’s chart by non-clinical staff. Approximately 1300 automated assays (Table 1) were conducted, with limited manual tube testing (~8%). TATs were acceptable, and surgeries proceeded without delays for Transfusion test results or products. Post-CSA, the initial seven days were manually ordered and resulted into the LIS system. The most recent 3 days of results had been electronically backed up and the test results were immediately uploaded into the patients’ electronic medical records. Conclusions: Experiencing unscheduled downtime, especially during a CSA, is challenging, but having a robust plan is crucial. Realizing that all testing must be taken off-line without access to the LIS is difficult. The ability to print individual patient results from the Echo Lumena was significant, allowing quick review and delivery to surgery or patient charts. This process prevented clerical errors and enabled techs to focus on more urgent needs during the crisis. Although we hope to never experience this situation again, it was impressive how automation allowed us to continue patient care with minimal disruption.
