A program developed by the Toronto General Hospital (TGH) Red Blood Cell Disorders Clinic, UHN Transfusion Medicine, Medical Day Unit and LifeLabs Medical Laboratory Services decreases patient trips to the hospital and cuts wait times for blood transfusions in half.
TGH patients can now have their initial blood drawn at a location near their home or work. These blood samples are then transported to the Blood Transfusion Laboratory at TGH where the sample is used to crossmatch the patient with donor blood in preparation for transfusion.
Having the samples collected and tested before patients come for their transfusions reduces time spent in clinic and the need to come to the hospital twice.
"This program has had a profound effect on our patient experience," says Kate Uchendu, Nurse Practitioner, UHN Red Blood Cell Disorders Program, who spearheaded the new process with a team from UHN Blood Transfusion Labs, UHN Red Blood Cell Disorders Program, LifeLabs and the Medical Day Unit.
Treatment times halved
She explains that treatment times for blood transfusions have been reduced from about eight to four hours. "Instead of spending an entire day with us, patients can get their transfusions, and still have time to do other things." She adds that, "the Medical Day Unit nurses worked long and hard to make this program a reality for our patients."
About 200 Red Blood Cells Disorders Clinic patients receive life-saving monthly blood transfusions at the TGH Medical Day Unit.
The program has also reduced the overtime of staff in the Medical Day Unit by more than half because patients' blood samples can first be taken in the community in preparation for their clinic visit, says Ina Cherepaha-Kantorovich, nurse manager of the Medical Day Unit.
Five LifeLabs Patient Service Centres (PSCs) in the GTA were chosen as community partners where patients could get their blood samples collected up to 72 hours before their transfusion appointment at TGH. UHN and LifeLabs worked together to incorporate each patient's hospital identification number into the collection process to securely link each blood sample to the correct patient.
Patients book their appointments at a LifeLabs PSC online, and bring their collection kit with tubes and labels, as well as their UHN patient identification numbers to the LifeLabs PSC. The samples are transported to TGH usually on the same day which allows the blood transfusion laboratory more time to match each patient's blood sample to compatible donor blood.
Transfusions can now start immediately
Sally Balmer, Manager of the Blood Transfusion Laboratories, explains that previously patients arrived at the hospital, had their blood drawn and then waited for at least two hours until the compatibility testing was completed. Now, she says, as soon as the patient arrives at the Medical Day Unit, the blood is picked up from the lab and the transfusion can be started immediately.
One patient, Kayla, had to previously travel 320 kilometres in total to TGH every month to first have her blood taken and matched to a donor's, and then come back on another day for her transfusion. The 25-year-old woman is developmentally delayed and partially paralyzed.
Being able to go to a designated LifeLabs PSC in Oshawa instead of driving to Toronto has provided relief for Kayla and David, 71, her foster dad, who has been taking care of her for 18 years.
'It normalizes her life'
"It's such a weight off my mind to not be on the road so much," says David, "Kayla is so much more calm, and the whole day is no longer spent at the hospital. It normalizes her life, she can go to her program, and I get a bit of a break too."
Hassan, 40, comes to TGH every four weeks to receive a blood transfusion. "My life changed when I came to this program," he says. "Nobody wants to sit around and wait for a whole day."
His time in clinic has been cut by about four hours since he now gets a blood sample drawn in Oshawa the day before he comes to the TGH clinic.
"When I come for my transfusion, my blood is in the Medical Day Unit refrigerator, ready to go," Hassan says smiling. Over time, this makes a huge difference to him and other patients. "Remember, once a month I'm getting poked for the rest of my life.
"And I don't like needles, so the faster and easier this is, the better for me."