Bleeding issue: a quality improvement project on the phlebotomy service at the Royal Devon and Exeter Hospital

Blood tests form an important part of a patient’s journey through hospital; they play a vital role in decision-making. At our large distric general hospital (DGH), it was identified that proportion of blood tests requested to be taken by phlebotomists were not being done, this impacting on clinical decision making. We conducted a quality improvement project to improve the proportion of blood results available to the medical team, in a timely manner to alter patient management during normal working hours. Issues identified highlighted poor communication of failed venepuncture attempts between the phlebotomy team and the ward junior doctors. Data were collected on 24 consecutive weeks, on one medical and one surgical ward. Blood samples requested to be taken on the phlebotomy round were measured against the proportion of results published by 15:00. Our interventions designed included highlighting pre-existing communication methods between phlebotomists and junior doctors through a pre-existing WhatsApp group, introducing a new mechanism of communication via the ward clerk and publication of a flowchart of the new system. The average number of patients for whom venepuncture was requested varied between the two wards, with the medical ward averaging 16.3 patients and the surgical ward averaging 19.1 patients per day. The mean number of results back by 15:00 …