Blood Samples Rejection Report
Clients: Groote Schuur Hospital, National Health Laboratory Services, Western Cape Department of Health
Duration: 01/2013 - 03/2013
![]() Phlebotomy in ActionThis phlebotomist draws blood for over 150 patients per day and stores them in a temperature-unregulated cardboard box. | ![]() Courier and VehicleThis courier took us through his route on three separate days to over 60 primary health care facilities. |
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![]() Blood CentrifugationBlood samples are processed in a laboratory and a Department of Health representative explains the steps. | ![]() Laboratory TechnicianLab techs register blood samples and label them with stickers. |
![]() Interviewing PhlebotomistsInterviewing a phlebotomist revealed they occasionally use expired tubes knowingly. | ![]() Reasons for Specimen RejectionThe top reasons for rejection are identified using a custom Excel keyword algorithm analysis. Reasons in orange are caused by phlebotomists. Out of respect for our client, the reasons are blurred. |
Understand.
Laboratory technicians must 'reject' blood samples if they are improperly collected or transported. Interviewing phlebotomists, blood sample couriers, and laboratory technicians, observing blood collection, and analyzing rejection data elucidated the primary causes for rejection.
![]() Blood Sample Data FlowSynthesized diagram indicating location, possession, point of origin, and exchange of test orders, test results, and blood samples. | ![]() Blood Sample Data Flow 2These two methods illustrated how phlebotomists do not receive the test results to know if or why a sample was rejected. |
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![]() Blood Transportation StoryboardAn abbreviated blood transportation storyboard used to identify knowledge gaps in process and identify error-prone steps for phlebotomists, technicians, and couriers. |
Create.
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Creating storyboards and process flows provided a deeper understanding of the blood sample's journey. Presenting these to Hospital Laboratory Supervisors identified their sphere of influence for reducing rates of sample rejection.
![]() 2013 NU GHT ProgramThe 2013 Northwestern University Global Healthcare Technologies Team worked on 3 separate biomedical engineering projects in Cape Town South Africa. Future GHT teams will pick up where this group left off. | ![]() Phlebotomist Feedback LoopLaboratory staff agreed that they should provide phlebotomists personalized data on their phlebotomy collection performance and agreed to do so. |
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Implement.
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Hospital Laboratory staff agreed to independently implement the closed-loop feedback concept. The Northwestern Global Healthcare Technologies program received a 70+ page report detailing the interview and observation findings for future teams to pick up.