Diagnosis-based laboratory information system flags to support specialized transfusion protocols in sickle cell disease.

Abstract

Objective: Patients with sickle cell disease (SCD) frequently require specialized transfusion support. However, the blood bank cannot readily identify these patients without a time-prohibitive chart review. To improve adherence to evidence-based practices involving the transfusion of patients with SCD, we developed a laboratory information system (LIS)-integrated flagging system.

Study design and methods: Using a predefined set of SCD-related International Classification of Diseases-10 diagnosis codes, laboratory-facing flags were implemented within the LIS. Flags were displayed in multiple workflow locations, including the patient dashboard, blood bank specimen receiving interface, and blood bank outstanding work list.

Results: Blood bank technologists used the flags to verify and apply the institution's existing sickle cell transfusion protocol within the blood bank information system (BBIS). Thirty-three new patients with confirmed SCD but without historical comment in the BBIS had a type and screen performed after the implementation of the flag. Upon review, 4 (12%) did not have SCD-related diagnosis in their problem list and therefore lacked the trigger for the flag. Twenty-nine (88%) patients had the diagnosis in the problem list and all of them (100%) correctly displayed the flag.

Discussion and conclusion: The intervention provided additional alerts of patients with SCD across multiple laboratory workflows and aided in the recognition of eligible patients.