My own blood bank's ISBT implementation was not quick or easy. If I could do everything again, I would do things quite differently. Hopefully a review of my own mishaps will help you plan your own ISBT implementation more effectively.
First, I delayed my own implementation with the excuse that I did not believe that ISBT would give the department enough "bang for the buck." Higher expenses and increased complexity of workflow resulting from ISBT implementation at a time of reduced resources would far outweigh any benefits. I still believe that to be true post-implementation. But eventually, I realized I was using this opinion as an excuse not to begin implementation. In the end my opinion did not matter; ISBT was not going away and ISBT components would soon be in my inventory. Basically, I determined it would be much less stressful for all concerned to get on with it and finish the project!
Looking back, I now realize that three areas should have been better explored before I began the project. First, my learning curve was longer than anticipated. Second, I thought the ISBT capabilities of our computer system might be sufficient for the department's ISBT needs. I discovered that just because a system had ISBT capabilities does not necessarily mean these capabilities will be sufficient for the department's needs. Third, I should have analyzed the scope of the project to a greater extent. As an experienced blood banker, in the past when I have begun a project I usually had a fairly good idea as to its complexity and scope. In this case, even though I had attended numerous ISBT workshops over the years, I really did not understand what the implementation of the system would entail. I should have read information available from ICCBBA more thoroughly before going forward. As a result, my learning curve was of much greater length than anticipated, I belatedly realized my computer software could not fulfill the department's needs and additional printers and scanners had to be requested, and the project was much more complex than I had anticipated. As a result, ISBT implementation took much longer than I anticipated or than was necessary.
I did realize that it would be important to minimize the time frame when both Codabar and ISBT components would be used concurrently in the blood bank. I attempted to coordinate ISBT implementations of with my own transfusion service and donor room. Ultimately this was thwarted by "floating" implementation dates of outside blood sources and unexpected computer software limitations of our in-house donor computer. As a result, the blood bank has had to handle both Codabar and ISBT labeling for an extended period of time.
Most importantly for planning purposes, I needed to determine to what extent ISBT would impact my own hospital blood bank. A minimally impacted blood bank would have one outside blood source that doesn't import, transfusion of a limited variety of components, and component modifications performed outside of the blood bank. Additionally, a minimally impacted blood bank would either be non-computerized or have software without barcode capabilities and no in-house donation center. At the other end of the spectrum, an example of a greatly impacted blood bank would be one with multiple outside sources of blood that import with component modifications performed in-house. That blood bank would also receive both Codabar and ISBT components, would have an in-house donation center, and computer server software with barcode capabilities for on-demand printing. My own blood bank unfortunately perfectly fitted the "greatly impacted" scenario.
My first incorrect assumption: I thought I could gain knowledge of ISBT by devoting an hour here and half-an-hour there and that I could implement ISBT without reading all the basic information on the subject. Didn't work, never does--I never learn. Until I devoted an entire day, no interruptions, to ISBT research, I floundered (it's amazing what one can learn by reading!). Don't have time to do this? I bet you take vacation days and somehow the blood bank survives without you. After I devoted time to reading basic information, ISBT didn't seem half as complicated.
Second wrong assumption: I thought that since my current sun-setting computer software had ISBT tables, it could be utilized for ISBT. Wrong, never assume. The programmers who wrote the ISBT section for the software had next to no knowledge regarding how ISBT is used in the blood bank.
I could go on in this vein for some time, but I do have some pride. So this is what I would do if I could do it all over again...
If you follow the steps outlined, there will be less chance your ISBT implementation will be delayed, while you complete overlooked items. Your project is more likely to be on time and hopefully less stressful.
Regardless, be wary of setting a concrete completion date with your manager!
David Linnemeyer has enjoyed 26 years' experience in blood banking and is the manager for the East Jefferson General Hospital Blood Bank in New Orleans. He has served as an AABB assessor for 20 years and lectures at meetings and conventions regionally and nationally. Linnemeyer also lectures in New Orleans' medical technologies and blood bank specialty schools. Contact him at firstname.lastname@example.org.
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