[A Project to Improve the Time-Effectiveness of Routine Morning Blood Tests].
OBJECTIVE
Morning blood sampling, conducted around 4am to 5am, is routinely ordered due to nothing-by-mouth (NPO) requirements and clinical practice norms. However, this routine may interrupt the normal sleep of patients and decrease the satisfaction of patients with the care received. However, our night-shift staff is not able to take all blood samples during this time, resulting in a high rate of overdue reporting.


OBJECTIVE
To reduce the overdue rate of laboratory result from 62.3% to less than 19.3%.


METHODS
In 2013, we performed interventions including the process reengineering of blood sampling to meet the needs of laboratory result flows and the upgrading of equipment in our neurology ward. The reengineering strategies used included the redistribution of blood sampling times in order to decrease testing for unnecessary items. The equipment upgrades improved the ability of the carrier in the pneumatic tube systems to carry the chilled blood samples. An independent two-sample t-test was used to compare the overdue rate before and after the interventions.


RESULTS
The overall overdue rate for the blood sampling to laboratory flow improved from 62.3% before the intervention to 18.0% (t = 7.07, p < .001) after the intervention. Furthermore, the overdue rate for the testing done at the stat laboratory improved from 66.9% to 21.3% (t = 7.36, p < .001), while the overdue rate for the testing done at the non-stat laboratory improved from 52.4% to 17.8% (t = 5.37, p < .001). Besides, the satisfaction of both inpatients and nurses with regard to blood-sampling flow improved from 51% and 54.2%, respectively to 93% (t = 51.10, p < .001) and 94% (t = 12.26, p <.001).


CONCLUSIONS
Our process reengineering strategies and the upgrading of the pneumatic tube system successfully reduced the overdue rate for the blood sampling and increased the satisfaction of inpatients.
Department of Nursing, Chang Gung Memorial Hospital, Linkou, Taiwan, ROC.
Chia-Yi
CY
Lo
Department of Nursing, Chang Gung Memorial Hospital, Linkou, Taiwan, ROC.
Lun-Hui
LH
Ho
Department of Nursing, Chang Gung Memorial Hospital, Linkou, Taiwan, ROC.
Yung-Han
YH
Ho
Department of Nursing, Chang Gung Memorial Hospital, Linkou, Taiwan, ROC. e221119@cgmh.org.tw.
Yu-Li
YL
Lin
Department of Neurology, Chang Gung Memorial Hospital, Linkou, Taiwan, ROC.
Chi-Hung
CH
Liu
Department of Laboratory Medicine, Chang Gung Memorial Hospital, Linkou, Taiwan, ROC.
Tien-Hui
TH
Wu
D001800:Blood Specimen Collection; D006403:Hematologic Tests; D006801:Humans; D017060:Patient Satisfaction; D013997:Time Factors
blood sampling; inpatient satisfaction; overdue rate; process reengineering