'Flagging' abnormal blood bank test results

A transfusion service medical director reports that his laboratory received an inquiry from an physician as to why the transfusion service computer does NOT flag abnormal results. The complaint referenced an obstetrical patient with a positive antibody screen. The transfusion service medical director's answer was that their "best-of-breed" transfusion service computer does not support results flagging. The inquiring colleague is interested in hearing thoughts about whether transfusion service computer systems should support results flagging, and if so, which results should be flagged. For example, if the computer could flag a positive antibody screen or a positive direct antiglobulin test, should these results be flagged? Should other blood bank abnormal results be flagged? Do any institutions currently use a computer system that flags abnormal blood bank results, and if so, which ones?

The following replies were submitted in response to the above:

ADDENDA Mar. 30, 2009

1. A blood banker in Indiana reports that their blood bank computer system does not flag abnormal "Antibody-type" or "Crossmatch-type" results. Therefore, they define certain results as critical, requiring the blood bank staff to call an appropriate person. A new positive antibody screen on an obstetrics patient is on their critical list, as is an incompatible crossmatch. Their system will flag "Test-type" results as abnormal. A positive DAT will flag as abnormal. As with any computer system, they manage its quirks by developing workarounds.

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