Pause the Draw

December 2018 - June 2021

St. Michael’s Hospital ReBDI Study Supervisor: Dr. Lisa Hicks Hematology/Oncology Clinical Research Group

Pause The Draw

Prior to starting my Masters of Architecture, I worked for 2.5 years as a Clinacal Research Assistant with the Hematology/Oncology Clinical Research Group (HOCRG) at St. Michael’s Hospital in Toronto. I gained valuable experience coordinating the ReBDI Study, a quality improvment project in the Medical-Surgical Intensive Care Unit (MSICU). The objective of the project was to reduce repetitive blood draws in the MSICU and the potential harm this can have on patients. Critically ill patients in the ICU receive intensive amounts of blood tests and monitoring each day, many of which are essential for their care. However, mounting evidence suggests that a significant proportion of blood testing in the ICU is reflexive and unnecessary. This project thus involved carefully understanding the primary drivers for for reflexive blood testing and implementing effective change strategies into daily pratice to minimize patient harm.

Two research projects were completed as part of this project. Analzying historial laboratory data, we were able to identify that ICU phlebotomy was associated with hospital acquired anemia and need for red blood cell transfusion. Building upon this research and implementing several different change strategy into the MSICU over two years, we successfully reduced ICU phlebotomy averages and sustained this change to this day.

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Plos One

RESEARCH ARTICLE

Patient harm associated with serial phlebotomy and blood waste in the intensive care unit: A retrospective cohort study

Thomas Bodley ID1,2* , Maverick Chan3, Olga Levi2,3, Lauren Clarfield2, Drake Yip4, Orla Smith2,3, Jan O. Friedrich1,2,3, Lisa K. Hicks2,3,5

1 Interdepartmental Division of Critical Care, University of Toronto, Toronto, Ontario, Canada, 2 Department of Medicine, University of Toronto, Toronto, Ontario, Canada, 3 Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Ontario, Canada, 4 Division of Laboratory Medicine, St. Michael’s Hospital, Toronto, Ontario, Canada, 5 Division of Hematology/Oncology, St. Michael’s Hospital, Toronto, Ontario, Canada

Quality Improvement Report

* thomas.bodley@mail.utoronto.ca

► Additional supplemental material is published online only. To view, please visit the journal online (http://dx.doi org/10.1136/bmjqs-2022015358).

For numbered affiliations see end of article

Correspondence to Dr Thomas Bodley, Department of Medicine, University of Toronto, Toronto, Canada; thomas bodley@mail utoronto ca

Received 13 July 2022

Accepted 23 December 2022

OPEN ACCESS

Citation: Bodley T, Chan M, Levi O, Clarfield L, Yip D, Smith O, et al. (2021) Patient harm associated with serial phlebotomy and blood waste in the intensive care unit: A retrospective cohort study. PLoS ONE 16(1): e0243782. https://doi.org/ 10.1371/journal.pone.0243782

Abstract

Background