Transforming transfusion safety: Insights from implementing bedside electronic checks at a large UK National Health Service trust

TL;DR

This paper describes how implementing electronic checks for blood transfusions improved safety and reduced errors in UK hospitals.

Contribution

The study provides practical insights into the implementation of bedside electronic transfusion checks across multiple hospitals.

Findings

Training 80% of staff improved BETC adoption compared to 60%.

BETC usage for G&S labelling reduced sample rejection rates.

Staff reported high satisfaction with the training program.

Abstract

Bedside electronic transfusion checks (BETC) enhance transfusion safety by reducing errors associated with manual processes. Despite national recommendations, BETC adoption in the United Kingdom remains limited. This study reports on the implementation of BETC at four hospitals at Barts Health NHS Trust, aiming to share insights on the implementation process.

The main implementation was split into three phases: (1) pre‐pilot, (2) pilot and (3) main implementation (2022–2025). Staff surveys on training satisfaction and key performance indicators (KPIs) on transfusion activity were used to evaluate the uptake of the BETC system. Statistical process control (SPC) charts were used to identify trends, variation and patterns in the data following the implementation of BETC.

A total of 5079 staff were trained and 404 personal digital assistant (PDA) devices deployed across four hospitals. Early implementation highlighted that training 60% of staff was insufficient for optimal system use, increasing this threshold to 80% improved adoption. BETC was initially more commonly used for blood administration than group and screen (G&S) sample labelling. Over time, increased usage of BETC for G&S labelling correlated with a marked reduction in sample rejection rates across all sites. Staff reported high satisfaction with training, with 99.5% rating it positively.

Early adopters played a pivotal role, but achieving widespread adoption required extended training and support. Addressing technical and workflow barriers, coupled with mandatory system use, could enhance the speed of impact of BETC. These insights offer guidance for future adopters aiming to improve transfusion safety and efficiency.

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