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Campaign to reduce sample rejections is a big success

Reject Me Not poster

A campaign aimed at reducing the number of blood samples which have to be rejected by our laboratories is proving to be highly successful.

The Reject Me Not campaign is being rolled out across Central Manchester University Hospitals and significant improvements are being seen wherever it is introduced.

Figures from Saint Mary's Hospital demonstrate just how effective the scheme has been, with some areas having seen the number of rejected samples fall by around half:

  • The number of Haematology samples from the Neonatal Intensive Care Unit (NICU) which had to be rejected fell by 56%, while the number of rejected Transfusion samples fell by 45%
  • In Gynaecology, rejected Transfusion samples fell 48% in four months, while the number of rejected Haematology samples dropped 47%
  • In Obstetrics, the number of Haematology samples that were rejected plummeted 40% in just one month

Fewer rejected samples mean there is less need to re-bleed patients to obtain new samples, so improving the patient experience.

The campaign is the brainchild of Marie Green, Lead Transfusion Practitioner for Patient Blood Management, who came up with the idea after spending time supporting clinical areas as part of a donor blood management project.

As part of that project, the Haematology department provided the clinical areas with reports showing how many blood samples were being rejected and highlighted the risk this has for our patients in delays to receiving treatment.

Clinical staff are trained in venepuncture before taking blood samples and are assessed at the end of their training. They are also told about the standards expected to avoid sample rejections and there are policies in place to support this.

Marie looked at the process surrounding blood sample taking to identify why errors were occurring and then set about trying to find a solution.

She considered other industries that have risks in processes and in particular how the aviation industry ensures checklists are followed. As clinical staff take blood samples so often, the process can be compared to being on autopilot.

Her idea was to introduce a decision tree, with a three-stage process, that makes people critically evaluate their own work and gives the opportunity to check the sample meets the criteria before sending to the laboratory.

The initial trials were a success, prompting our tube supplier Sarstedt to come on board and produce some special pens with a pull-out sheet featuring the Reject Me Not message.

The scheme is being rolled out across CMFT, with a number of other trusts now showing interest in adopting the idea.