Weekend Diagnosis: New ways of working

Published: 3 August 2016

Mairead McAlindenThis Weekend Diagnosis is from Mairead McAlinden, our Chief Executive

There are lots of team across our Trust who are trying new ways of working to improve the care we provide, a person’s experience and the care pathway. Many of these new ways of working are also helping to ease the pressure in our system.

One group of colleagues who are making a real difference is the Patient Blood Management Group (PBMG). Some of their work is making improvements to reducing a person’s length of stay, their chance of being readmitted and enhancing their post-operative recovery and longer term life expectancy. By reducing length of stay, the pressure on our wards and in our system is also eased.

Over the last 18 months, the team has done a lot of work to expand the cell salvage programme in our theatres. Cell savage works by recycling a patient’s blood for reinfusion back into their body during a procedure. Every bit of blood possible is recycled and specialist technology is used to do this. By implementing cell salvage in every area possible we can reduce or avoid a patient’s need for a blood transfusion altogether. This is much safer for patients, with fewer complications, faster recoveries and shorter stays.

Cell savage is almost standard procedure now in many areas of our hospital and we are a local leader in working this way. Orthopaedics, obstetrics and gynaecology and vascular surgery all use cell salvage routinely in their procedures.

In 2014 around 193 units of blood were recycled, at our Trust, using cell salvage, last year that figure was 337 units and this year we are hoping to use over 400 units, this equates to around 100,000ml of blood. By doing so, we have also seen a knock on financial effect with savings of around £20,000 and a reduction in the amount of donated blood that needs to be stored on site. In the last two years, storage of blood has been reduced by 38 per cent at Torbay Hospital.

Although this is great news, the team know that they can still reduce the need for a transfusion even further with the help of colleagues and the wider local health system.

In more recent months the group have been working to drive even more change and improvements. They will be mainly concentrating on improving the pre-operative procedure for patients, particularly those who are anaemic. Paperwork has been adapted to provide more detailed guidelines on the procedure clinicians should follow, a new IT system is being implemented to improve the data captured from procedures about the patient’s outcomes and a campaign to encourage the use of single unit transfusions, if a transfusion is needed will also start shortly. This is because the less donated blood a person receives the better for their overall recovery. Work is also happening with local GP’s and staff to look at improving the health for people before a non-urgent elective procedure, this could involve iron supplements or tackling an underlying cause of anaemia to help people be in the best possible health they can be before having an operation.

As you can see from work like this, lots go on behind the scenes to enhance the way we care for people and their experiences. Many people only see what goes on at the ‘front door,’ so to speak, but we are continually looking at way in which can improve experiences and outcomes, as well as ways in which we can work more effectively and efficiently. The work being carried out around blood management highlights just one of the ways in which our Trust is doing this.