Benefits of VISION Max automated cross-matching in comparison with manual cross-matching: A multidimensional analysis.
Journal
PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081
Informations de publication
Date de publication:
2019
2019
Historique:
received:
31
05
2019
accepted:
26
11
2019
entrez:
24
12
2019
pubmed:
24
12
2019
medline:
16
4
2020
Statut:
epublish
Résumé
VISION Max (Ortho-Clinical Diagnostics, Raritan, NJ, USA) is a newly introduced automated blood bank system. Cross-matching (XM) is an important test confirming safety by simulating reaction between packed Red Blood Cells (RBCs) and patient blood in vitro before transfusion. We assessed the benefits of VISION Max automated XM (A-XM) in comparison with those of manual XM (M-XM) by using multidimensional analysis (cost-effectiveness and quality improvement). In a total of 327 tests (130 patients), results from A-XM and M-XM were compared. We assessed the concordance rate, risk priority number (RPN), turnaround time, hands-on time, and the costs of both methods. We further simulated their annual effects based on 37,937 XM tests in 2018. The concordance rate between A-XM and M-XM was 97.9% (320/327, kappa = 0.83), and the seven discordant results were incompatible for transfusion in A-XM, while compatible for transfusion in M-XM. None of the results was incompatible for transfusion in A-XM, while compatible for transfusion in M-XM, meaning A-XM detect agglutination more sensitively and consequently provides a more safe result than M-XM. A-XM was estimated to have a 6.3-fold lower risk (229 vs. 1,435 RPN), shorter turnaround time (19.1 vs. 23.3 min, P < 0.0001), shorter hands-on time (1.1 vs. 5.3 min, P < 0.0001), and lower costs per single test than M-XM (1.44 vs. 2.70 USD). A-XM permitted annual savings of 46 million RPN, 15.1 months of daytime workers' labor, and 47,042 USD compared with M-XM. This is the first attempt to implement A-XM using VISION Max. VISION Max A-XM appears to be a safe, practical, and reliable alternative for pre-transfusion workflow with the potential to improve quality and cost-effectiveness in the blood bank.
Sections du résumé
BACKGROUND
VISION Max (Ortho-Clinical Diagnostics, Raritan, NJ, USA) is a newly introduced automated blood bank system. Cross-matching (XM) is an important test confirming safety by simulating reaction between packed Red Blood Cells (RBCs) and patient blood in vitro before transfusion. We assessed the benefits of VISION Max automated XM (A-XM) in comparison with those of manual XM (M-XM) by using multidimensional analysis (cost-effectiveness and quality improvement).
MATERIALS AND METHODS
In a total of 327 tests (130 patients), results from A-XM and M-XM were compared. We assessed the concordance rate, risk priority number (RPN), turnaround time, hands-on time, and the costs of both methods. We further simulated their annual effects based on 37,937 XM tests in 2018.
RESULTS
The concordance rate between A-XM and M-XM was 97.9% (320/327, kappa = 0.83), and the seven discordant results were incompatible for transfusion in A-XM, while compatible for transfusion in M-XM. None of the results was incompatible for transfusion in A-XM, while compatible for transfusion in M-XM, meaning A-XM detect agglutination more sensitively and consequently provides a more safe result than M-XM. A-XM was estimated to have a 6.3-fold lower risk (229 vs. 1,435 RPN), shorter turnaround time (19.1 vs. 23.3 min, P < 0.0001), shorter hands-on time (1.1 vs. 5.3 min, P < 0.0001), and lower costs per single test than M-XM (1.44 vs. 2.70 USD). A-XM permitted annual savings of 46 million RPN, 15.1 months of daytime workers' labor, and 47,042 USD compared with M-XM.
CONCLUSION
This is the first attempt to implement A-XM using VISION Max. VISION Max A-XM appears to be a safe, practical, and reliable alternative for pre-transfusion workflow with the potential to improve quality and cost-effectiveness in the blood bank.
Identifiants
pubmed: 31869405
doi: 10.1371/journal.pone.0226477
pii: PONE-D-19-15459
pmc: PMC6927601
doi:
Types de publication
Comparative Study
Evaluation Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0226477Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
Références
BMJ. 2016 May 03;353:i2139
pubmed: 27143499
J Clin Lab Anal. 2018 Jun;32(5):e22400
pubmed: 29479855
Vox Sang. 2011 Apr;100(3):298-302
pubmed: 20738838
J Lab Physicians. 2017 Apr-Jun;9(2):71-75
pubmed: 28367018
BMC Health Serv Res. 2018 Jul 4;18(1):521
pubmed: 29973258
Transfusion. 2013 Dec;53(12):3080-7
pubmed: 23560475
Transfusion. 2012 Aug;52(8):81S-87S
pubmed: 22882101
Arch Pathol Lab Med. 2004 Jun;128(6):663-7
pubmed: 15163233
Asian J Transfus Sci. 2011 Jul;5(2):157-9
pubmed: 21897596
Int J Health Care Qual Assur. 2015;28(1):2-10
pubmed: 26308398
Clin Chim Acta. 2009 Jun;404(1):75-8
pubmed: 19298799
Clin Chem. 2015 Dec;61(12):1446-52
pubmed: 26510957
Am J Clin Pathol. 2009 Mar;131(3):418-31
pubmed: 19228647
J Clin Lab Anal. 2018 Jun;32(5):e22373
pubmed: 29314254
Jt Comm J Qual Patient Saf. 2005 Mar;31(3):132-40
pubmed: 15828596
Transfusion. 2014 Jan;54(1):66-73; quiz 65
pubmed: 23672511
Transfusion. 2013 May;53(5):1077-82
pubmed: 23002928
Clin Biochem. 2017 Jul;50(10-11):605-611
pubmed: 28390779
J Lab Physicians. 2015 Jul-Dec;7(2):96-102
pubmed: 26417159
Emerg Med Int. 2014;2014:316463
pubmed: 25254117
Ann Lab Med. 2013 Jul;33(4):268-73
pubmed: 23826563
Ann Lab Med. 2019 Jan;39(1):43-49
pubmed: 30215229
Oral Surg Oral Med Oral Pathol Oral Radiol. 2013 Nov;116(5):534-9
pubmed: 24021773
Transfusion. 2019 Feb;59(2):516-523
pubmed: 30609064
Phys Ther. 2005 Mar;85(3):257-68
pubmed: 15733050
Clin Chem Lab Med. 2019 May 27;57(6):802-811
pubmed: 30710480
Vox Sang. 2003 Jul;85(1):40-7
pubmed: 12823729
Clin Chim Acta. 2015 Aug 25;448:80-5
pubmed: 26116892
Asian J Transfus Sci. 2016 Jan-Jun;10(1):48-52
pubmed: 27011670
Jt Comm J Qual Patient Saf. 2005 Sep;31(9):495-506
pubmed: 16255327
Transfus Med. 2013 Feb;23(1):3-35
pubmed: 23216974
J Clin Lab Anal. 2019 Jan;33(1):e22619
pubmed: 30030865
Vox Sang. 2000;78(2):113-8
pubmed: 10765147