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U.K. Health Agency Plans RFID Trial to Staunch Transfusion Errors

National Patient Safety Agency is seeking hospitals to participate in a 2007 trial, hoping to reduce the number of ABO-incompatible transfusions by 50 percent.
By Jonathan Collins
Aug 25, 2006The United Kingdom's National Patient Safety Agency (NPSA) is seeking hospitals to participate in a series of trials using bar-code or RFID technology to track blood products and reduce errors related to the administration of blood transfusions. The NPSA is a government-created organization that works to identify and eliminate medical mistakes and unsafe practices in the nation's health-care system.

The NPSA, the National Blood Transfusion Committee and a group named Serious Hazards of Transfusion (SHOT) are jointly developing an IT specification outlining how best to track blood electronically within the United Kingdom's network of National Health Service (NHS) hospitals. Set for publication later this summer, the specification will provide the blueprint for the trials, which are expected to start in March 2007.

The three organizations hope that if hospitals adopt an electronic system for tracking blood, this would prevent patients from being given the wrong blood types during transfusions.

According to SHOT, five patients in the United Kingdom died as a direct result of being given an incompatible blood type (A, B or O) between 1996 and 2004. ABO incompatibility contributed to the deaths of nine additional patients in the United Kingdom, and caused major morbidity in 54 patients.

While the National Blood Transfusion network does use bar-coded identification, most hospitals still use a paper-based manual system to track and manage patient blood samples and blood transfusions.

The new specification is based on a five-year project run by Oxford's John Radcliffe Hospital to develop a bar-code system for tracking and managing blood samples and transfusions. Using bar-coded wristbands for patients and bar-coded labels for blood samples, handheld PDAs with built-in bar-code scanners, and bar-code label printers, the hospital reduced a two-nurse 27-step procedure for dealing with blood transfusions at a patient's bedside down to a 16-step one-nurse process. Adoption of the system by the hospital has also reduced the chance of error.

RFID, the hospital believes, promises to bring additional benefits compared with the bar-code system. "It can be difficult to get access to a bar-coded wristband if the patient is strapped up for surgery," says Mike Murphy, professor of blood-transfusion medicine at the University of Oxford and consultant hematologist at John Radcliffe Hospital. "With RFID, you don't need a line-of-sight read, so that's a big advantage."

According to Murphy, there would be additional benefits if RFID were adopted by the National Blood Service, as well. "The blood service delivers 50 to 100 units to a hospital at a time, with four bar codes on each, which have to be read," he says. "With RFID, one scan could transfer details into the system immediately."

Once the IT specification is published later this summer, selected hospitals participating in the trial will be able to deploy either bar-code or RFID tracking, using the specification as a guideline to determine in which processes to use electronic tagging. The trial will be used to test and refine the IT specification, for a potential rollout across hospitals in the U.K. health-care system. The NPSA's goal is to reduce the number of ABO-incompatible transfusions by 50 percent within five years.

In September, the NPSA will publish an information pack containing full details of the pilot, including its scope, objectives and deliverables expected. The pack will also detail reporting arrangements, resources and how hospitals can apply to be part of the funded scheme.
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