The John Radcliffe Hospital is part of the Oxford Radcliffe Hospitals Trust, one of the largest teaching trusts in the UK. With approximately 600 beds, it is the biggest of the Trust's four hospitals and is the main accident and emergency unit for Oxfordshire. In total, the Trust conducts some 30,000 blood transfusions a year.
From 1996 to 2003, incorrect blood component use made up three-quarters of all official reports of serious incidents associated with the transfusion process in the UK, causing 13 deaths and 75 cases of serious ill effects. Professor Mike Murphy, Consultant Haematologist at John Radcliffe Hospital, explains: "Blood transfusion is a complex process and therefore subject to error. Patient identification is key to ensuring that patients receive the right blood. There are new regulations requiring full traceability of blood from the donor right through to the recipient."
John Radcliffe Hospital decided to develop with Olympus a system for end-to-end control of blood transfusion in work partly funded by the National Blood Service. The output was the Olympus osYris BloodTrack application suite, deploying the BloodTrack SafeTX ž and BloodTrack Courier ž modules. BloodTrack SafeTX uses a two-dimensional barcode on patient wristbands, on blood samples taken from patients, and on blood units for transfusion. BloodTrack Courier manages bloodstocks by controlling access rights to storage areas and physical transport between buildings.
The easy-to-use BloodTrack SafeTX process employs a handheld computer incorporating a scanner. An attached portable printer enables the instant creation of barcoded labels for blood samples. Software prompts ensure compliance with best practice protocol all the way from the refrigerators where blood is stored right to the patient's bedside. Initial deployment was in haematology, then cardiac surgery, and then the intensive care unit (ICU) where rapid and urgent blood transfusions are frequently necessary.
The next step has been to enhance the technology, adding clinically helpful features whilst improving the processing and availability of transfusion data. BT proposed a wireless infrastructure that would build on the established use of handheld scanners. Professor Mike Murphy says: "There are two important applications of the wireless link: to download data from the handheld unit directly into the blood transfusion computer; and to enable real time blood count information from pathology to the handheld unit, providing strong decision support for clinicians at the bedside."
The benefits of John Radcliffe's transfusion system will stretch from the clinical front line to the back office budget, and it has given the hospital a lead in complying with the new regulations for traceability of blood. Professor Mike Murphy says: "The main benefit is in terms of patient safety, by minimising the risk of the patient being transfused with the wrong blood." The number of blood transfusion process steps is reduced from 26 to 17, and the number of staff involved is reduced from two to one. If incompatibility is detected a visible and audible alert is sounded, ensuring that clinical staff know not to proceed with the transfusion.
Amanda Davies, a Senior ICU Nurse, explains: "The BloodTrack system helps to provide better patient care, because you can use the handheld computer at the bedside to check the process. Previously, we had to use two nurses to conduct a transfusion but now we only need one."
The BT wireless network will be expanded to cover the whole of John Radcliffe Hospital as well as the Trust's Churchill and Horton sites, so that the benefits of the BloodTrack system can be achieved on a Trust-wide basis. Under a managed service contract, the BloodTrack implementation risk is shared and, in the unlikely event that full benefits do not materialise, appropriate penalties are in place. The cost of the contract is phased to ensure that payment by the hospital is covered by the growing annual savings over the five-year contract term.
Simon Wombwell, Deputy Finance Director at John Radcliffe, concludes: "We now transfuse less blood, because the system is checking what we're doing. The BloodTrack system is costing £2 million over five years. We know that we'll save at least that amount. So the system will pay for itself. Moreover, the time savings equate to 15 extra nurses diverted to direct patient care rather than administration. That benefit is valued at another £500,000 per annum."
Understanding of the healthcare clinical and business environment, through in-depth involvement in NHS and private projects at national and local level
Flexible contract terms with risk sharing and annual running costs calibrated to savings as they grow
Track record in installation and maintenance of secure wireless networks, and expert assistance with system development
The BT wireless platform will support further added value applications such as BT Managed Vocera, phlebotomy management, pathology requesting, theatre optimisation and asset tracking.
Cisco-based wireless network comprising four Cisco 1000 Series lightweight access points within a Cisco Structured Wireless Aware Network (SWAN) with a 4400 Series Wireless LAN centralised controller
BT Professional Services including specialist engineering skills and comprehensive project management
