Re-useable Trays for Laboratory Sample Transport  

The benefits of this project

Opportunity for improvement

• Traditionally, each blood sample taken in General Practice is transported to hospital laboratories in one or more single-use plastic bags. These plastic bags, whilst effective at containment and prevention of contamination, contribute to the NHS’s carbon footprint both in supply and the required high temperature incineration to prevent risk of infection.   
• Using re-useable racks for transporting samples to the lab is a solution.  Indexor is one option to implement this. This is a simple to use sample transport RFID (radio-frequency identification) tracking system, where GP surgeries scan in their current patient barcode sticker from their electronically requested blood samples so no blood test request forms are needed. The scanned tube is placed into an iRack and the sample position, date and time of collection and collecting surgery is recorded onto an RFID tag inside the iRack. This RFID tag holds the barcode identification and associated test but does not hold any patient identification. The racks are collected by the courier service and placed into iLogger transport bags which commence recording the transport journey (time, temperature and impacts).   
• On receipt in the laboratory, the rack is docked, the request is downloaded straight into the laboratory system, and any urgent samples are notified to the lab operative using worklists. The system highlights any samples affected by time, temperature or impacts during the transport journey. The results appear in the GP’s pathology inbox in the same way as usual.   
• Please note: practices that currently centrifuge their samples because they are a long way from the hospital will need to continue to do that with Indexor.  
• This project outlines how to implement a similar system in your area (see disclaimers).
• You might like to create SMART goals for your project. Present the case study from the Royal Cornwall Hospitals to your practice team and the local laboratory lead team within the next month and discuss with them the possibility of piloting Indexor at your practice.  If they agree, trial Indexor at your practice over the next 3 months. 

How to carry out this project

How to scale this project up or down

Please note - Use of this project requires NetworkPLUS membership. If you would like to share this project with others, please invite them to purchase their own membership—access must not be shared with non-members.

You could upscale this project by working with your local ICB (England), Health Board (Scotland & Wales) or SPPG Pharmacy Advisor (Northern Ireland) to ensure once daily or alternate day dosing is the default pick in local formularies. 

You could take it to your Primary Care Network or Cluster to implement across all practices in your area. 

Case study

The Royal Cornwall Hospitals Trust Blood Sciences laboratory wanted a solution to the use of plastic bags to contain specimens transported to the laboratory from primary care facilities. They started using Indexor after an initial scoping project to ascertain the number of samples submitted from each surgery site to evidence benefits and assist with costings of required equipment.

Delivery of all equipment and the validation process commenced in April 2019, with LIMS (Laboratory Information Management Systems) interface developed in October 2019. Once initial surgery installation was completed and process pathways established, more surgeries were contacted to offer the plastic-free transport solution. The roll-out continued at pace with surgeries requesting installations (it just requires a plug socket) as the benefits of the plastic-free solution were realised.

The courier service was engaged at the very start and given iLogger bags. The logistics of transport and replenishment of racks to surgeries were determined and implemented.

Interface development to enable auto receipt in the laboratory commenced in July and was active by October 2019. 96% of all GP blood tests are now processed by Indexor with notable reductions in turnaround time and a fully auditable ability to review specimens throughout the journey to the lab. The project was rolled out across Cornwall by the end December 2019.

Use of the unit in each practice costs about £100 per month, but as 5 (WTE mid-point band 3) laboratory staff members did not need to be replaced when they left the service due to the reduced workload of inputting samples in the laboratory, and the reduction in plastic bags that need to be incinerated, this is a saving for the hospital.

This QIP experience was shared across the Peninsula network and then nationally as the Indexor roll-out in Cornwall was fully embedded across primary care.

Jo Walsh, Multiple GP practices, Cornwall

Have you completed this QIP?

Tell us a little about your project and enter your data in order to generate a certificate showing the probable cost savings and other benefits. This project may help with CQC evidence submission (see disclaimers).