Diagnosis‐based laboratory information system flags to support specialized transfusion protocols in sickle cell disease
Caroline G. Stanek, Ronald G. Hauser, Katherine Madden, Bhushan Shah, Christopher A. Tormey, Kerry Wallack, Nalan YurtseverAbstract
Objective
Patients with sickle cell disease (SCD) frequently require specialized transfusion support. However, the blood bank cannot readily identify these patients without a time‐prohibitive chart review. To improve adherence to evidence‐based practices involving the transfusion of patients with SCD, we developed a laboratory information system (LIS)‐integrated flagging system.
Study Design and Methods
Using a predefined set of SCD‐related International Classification of Diseases‐10 diagnosis codes, laboratory‐facing flags were implemented within the LIS. Flags were displayed in multiple workflow locations, including the patient dashboard, blood bank specimen receiving interface, and blood bank outstanding work list.
Results
Blood bank technologists used the flags to verify and apply the institution's existing sickle cell transfusion protocol within the blood bank information system (BBIS). Thirty‐three new patients with confirmed SCD but without historical comment in the BBIS had a type and screen performed after the implementation of the flag. Upon review, 4 (12%) did not have SCD‐related diagnosis in their problem list and therefore lacked the trigger for the flag. Twenty‐nine (88%) patients had the diagnosis in the problem list and all of them (100%) correctly displayed the flag.
Discussion and Conclusion
The intervention provided additional alerts of patients with SCD across multiple laboratory workflows and aided in the recognition of eligible patients.