Authors (including presenting author) :
K.W. Yeung, W.S. Leung, W.S. Yee, S.K. Chan, T.B. Hui
Affiliation :
Nursing Service Division, Pamela Youde Nethersole Eastern Hospital
Introduction :
The demand for inpatient phlebotomy services had increased considerably in recent years. As a result of increasing work stress and harsh working environments, a major issue has arisen from the high turnover rate and low morale among them. In-patient phlebotomy service plays an important role especially in septic patients as blood cultures must be done in a timely fashion. However, this might not be the case in all circumstances, as routine blood taking has already overwhelmed this urgent service. The daily in-patient phlebotomy demand is over 750 blood taking. Currently, there are 34 phlebotomists divided into two teams. The Medical Team and Non-medical Team. They work independently in different departments and wards. In hope to enhance the efficacy of phlebotomy service we decided to analysis the effectiveness of the two phlebotomy teams in order to identify any service gaps to cope with future phlebotomy demands.
Methodology :
The analysis period was between April 2016 to March 2018. We analyzed each team’s workload, their routing, their present workflow, staffing structures, timeliness of their services delivered and each phlebotomist’s morale.
Result & Outcome :
During the analyzed period a total of 1548 patients received their services, 579 performed by the Medical Team and 969 by the Non-medical Team. As each patient might have more than one blood taking, on average there were 798 blood draws per day of which 53% were done by the Medical Team and 46.9% by Non-medical Team. There are 15 phlebotomists in the Medical Team therefore each phlebotomist average 28.2 blood draws per day, and there are 19 phlebotomists in the Non-Medical Team averaging 19.7 blood draws per phlebotomist per day. On the timeliness of their services delivered the results show that 73% were done before 1pm when the request was ordered in the morning. In terms of staff attrition rate, it was 7.1% in 2016/17 and 14.3% in 2017/18. Heavy workload and low morale were the main reasons for staff leaving.
After analysis of the current inpatient phlebotomy services, we identified an imbalance of workloads between the two teams. We have proposed a new staffing schedule and rearrangement of routing to balance their workloads. As majority of services can be delivered by 1pm if orders are given in the morning, we encourage doctors to give their orders before 9am when possible. Methods to boost staff morale are necessary in the phlebotomy teams to reduce attrition rates as training new staffs require significant amount of time. Meanwhile, we are continuing to collect and analyze post-implementation metrics and analysis of outcome measures are still ongoing.
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