Electronic remote blood issue: a combination of remote blood issue with a system for end-to-end electronic control of transfusion to provide a "total solution" for a safe and timely hospital blood transfusion service.

BACKGROUND: The rapid provision of red cell (RBC) units to patients needing blood urgently is an issue of major importance in transfusion medicine. The development of electronic issue (sometimes termed "electronic crossmatch") has facilitated rapid provision of RBC units by avoidance of the serologic crossmatch in eligible patients. A further development is the issue of blood under electronic control at blood refrigerator remote from the blood bank. STUDY DESIGN AND METHODS: This study evaluated a system for electronic remote blood issue (ERBI) developed as an enhancement of a system for end-to-end electronic control of hospital transfusion. Practice was evaluated before and after its introduction in cardiac surgery. RESULTS: Before the implementation of ERBI, the median time to deliver urgently required RBC units to the patient was 24 minutes. After its implementation, RBC units were obtained from the nearby blood refrigerator in a median time of 59 seconds (range, 30 sec to 2 min). The study also found that unused requests were reduced significantly from 42 to 20 percent, the number of RBC units issued reduced by 52 percent, the number of issued units that were transfused increased from 40 to 62 percent, and there was a significant reduction in the workload of both blood bank and clinical staff. CONCLUSIONS: This study evaluated a combination of remote blood issue with an end-to-end electronically controlled hospital transfusion process, ERBI. ERBI reduced the time to make blood available for surgical patients and improved the efficiency of hospital transfusion.

Key facilitators and best practices of hotel-style room service in hospitals.

This qualitative study sought to identify the features, advantages, and disadvantages of hotel-style room service; the barriers to, and facilitators for, implementing the process; and "best practices." The study took place in four heterogeneous hospitals. Participants included hospital administrators, managers, and room-service employees. Data-collection methods included semi-structured interviews, observations, and document analysis. Common features of hotel-style room service were meal delivery within 30 to 45 minutes, a restaurant-style menu, procedures to feed ineligible patients, tray assembly on demand, scripting, and waitstaff uniforms for room-service employees. The major barrier to implementing room service was obtaining nursing support. The key facilitators were the hospital's service-oriented culture, using a multidisciplinary planning team, engaging nursing departments early in the planning stages, and intense customer-service training of room-service employees. The overwhelming advantage was patients' control over their food choices. The main disadvantage was cost. Initial best practices in hotel-style room service include: (a) taking a multidisciplinary team approach for developing and implementing the process, (b) customer-service training, (c) using a customer-driven menu, (d) wearing waitstaff uniforms, and (e) using carts with airpots for dispensing hot beverages.

Excellence in supply chain management--trends and strategies to enhance profitability. Panel discussion.

Supply-chain management--the art of getting the most at the least cost from the products and services purchased by an organization--has transformed industries such as manufacturing and retailing, and can potentially do the same for healthcare. VHA is committed to keeping its members educated on current thinking and best practices in supply-chain management. In support of that mission, four supply chain experts gathered in Chicago recently at Modern Healthcare's offices to discuss the issues they face in their organizations and the strategies they've found most successful in addressing them.

Benchmarking as a tool for the improvement of health services' supply departments.

This paper presents a benchmarking study carried out on the supply departments of Quebec's health services. The paper begins with the definition of a methodology to collect the information needed, both environmental (to enable institutions to be sorted into homogenous groups) and performance related. The analysis of indicators and the data envelopment analysis (DEA) models allowed classification of each hospital's performance and explained the operational approaches used, either at a general level or for each subprocess of the supply chain. It was observed that important economies of scale may be achieved with better co-ordination and with the regrouping of the supplying activities, both for purchasing management and central store management. The study showed that the best performance of central store services comes with flexible administrative structures, by receiving packages as small as possible and by using employees from the lowest range of the hierarchy. Purchasing services should employ highly qualified and well-paid staff. Although such services are relatively small with respect to their purchase volume, they show a higher activity rate. As a result of the discovered performing strategies, the possible economies range from 20% to 30% of the actual supply-chain management cost.

Improving risk management systematically.

The management of risk is an ever more prevalent issue amongst healthcare professionals due to key changes in recent years driving visibility and transparency. Medical gases constitute an important area of risk--the gases are used, administered and handled by many different people and the chief executive is ultimately responsible. Such risks can be managed down by a hospital according to the letter and spirit of HTM 2022, EN737 and NMSR. The biggest failing of the current system where hospitals take it upon themselves to ensure compliance, is that typically little training is actually performed, there is almost no monitoring, and often people on the front line are unaware of the risks that they are running. A systematic response to managing risk is the only way forward, and a key decision a hospital needs to make is whether to persist towards this goal itself, or to involve a technical and clinical supplier. BOC Medical is in a key position to be of value.

Improving the blood product ordering to administration process.

UNLABELLED: A four-pronged approach to improving the blood product delivery system resulted in a significant decrease in the number of blood products ordered STAT, increased ability of the blood bank to fulfill STAT requests in a timely manner, and a significant decrease in the number of blood products outdated and discarded. KEYWORDS: blood products, performance improvement

La gestión de materiales, medicamentos, en la farmacia hospitalaria / The management of materials, medicines, in the hospital pharmacy

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[Supply services at health facilities: measuring performance]. / Los servicios de suministros de los establecimientos sanitarios: la medición de la performance.

Performance measurement, in their different meanings--either balance scorecard or outputs measurement--have become an essential tool in today's organizations (World-Class organizations) to improve service quality and reduce costs. This paper presents a performance measurement system for the hospital supply chain. The system is organized in different levels and groups of indicators in order to show a hierarchical, coherent and integrated vision of the processes. Thus, supply services performance is measured according to (1) financial aspects, (2) customers satisfaction aspects and (3) internal aspects of the processes performed. Since the informational needs of the managers vary within the administrative structure, the performance measurement system is defined in three hierarchical levels. Firstly, the whole supply chain, with the different interrelation of activities. Secondly, the three main processes of the chain--physical management of products, purchasing and negotiation processes and the local storage units. And finally, the performance measurement of each activity involved. The system and the indicators have been evaluated with the participation of 17 health services of Quebec (Canada), however, and due to the similarities of the operation, could be equally implemented in Spanish hospitals.

Establishing and maintaining efficient courier services.

Your couriers are your link to your outreach customers. They represent your facility to and carry information (and, of course, specimens) from the communities you service. When establishing your outreach program, who is in the driver's seat and how specimens will be transported are primary concerns. Cost-conscious laboratorians rely on a variety of courier options, from transporting specimens on foot using refrigerated Styrofoam nylon packs to calling taxis to contracting with drivers to having a dedicated arrangement with in-house employees. Often, the expense and bother of maintaining a fleet of cars and drivers, probably most desirable in terms of control and standardizing processes, forces laboratory managers to seek alternatives that may not sound practical or reliable, but that actually do work quite well. Whatever courier route you choose, you should emphasize to your carriers the respect you have for the precious cargo they carry. Of course, there must be no doubt about specimen integrity, carefully and conscientiously maintained from its source to you. But the integrity of your organization is also in the hands of those who accept the responsibility of bringing you all of those potential questions to be answered. Your livelihood depends on it. Just be as certain as possible that your customers want to celebrate--not shoot--your messenger.