This wiki has undergone a migration to Confluence found Here
<meta name="googlebot" content="noindex">

BTO Storyboards v3

From HL7Wiki
Jump to navigation Jump to search

Link back to BTO Storyboards


1 Introduction

This set of storyboards covers the different cases that follow a blood donation and transfusion processes. It is intended to cover blood, tissues & organs in future.

2 Donation Order POBB_ST002000

2.1 Purpose

This set of Storyboards defines the process of a donor registration at a Blood Bank. There are 3 different cases at this point; Volunteer donation, directed donation and autologous donation.

2.2 Donor Identification

A person arrives at the Blood Bank and is identified as an existing donor or new donor. Certain identifying information is collected from the potential donor and used in this process. Information may include; name, DOB, gender, mother’s maiden name, etc. The information collected is specific to the organization. The donor identification process is a most critical step in the overall donation process. After the prospective donor has been positively identified, he/she is registered on the system as a donor candidate. New donors are given a new permanent ID and previous donors use their previously assigned ID. This person can try donating blood for a known person’s sake (directed donation), for no one in particular (volunteer donation), or for himself/herself (autologous donor).

Here, a unique Donation Identification number is assigned or generated and will distinguish his/her blood samples and blood products throughout the entire process, in order to identify them for example in case of adverse reactions or positive lab results, etc.. This ID has been established as mandatory by International Regulations.

2.3 Donor Registration

The person fills in a questionnaire in order to determine if he/she is eligible for donating his/her blood. Depending on the results of the donor questionnaire, an initial eligibility is determined. There are certain qualifications a donor must meet in order to go to the next step of the donation process. If eligible to donate, one of several donation processes is started and continued until complete. A sample of blood is taken to the laboratory for haematological tests.

2.4 Volunteer Donation

Bill Jones has wanted to donate blood for some time and has arrived at the donation center to go through the process. His blood donation will be used as needed for anyone in need of a transfusion. After his initial eligibility screening has been successfully completed, he is ready to proceed with the donation. There are various types of blood donations he can make and Bill has decided to donate whole blood on this visit.

2.5 Directed Donation

John Smith is a patient at The Greenhouse Hospital. He needs a transfusion and his relatives go to the Blood Bank for donating blood in his sake. At the Blood Bank reception Susan Smith, sister of John Smith, is asked by the receptionists her demographics information, and is given a questionnaire that has to fill in. This has questions regarding previous diseases, pregnancy, received donations, etc. Her unique patient ID and donation ID are generated. A blood sample will be taken to the lab for haematological tests and will wait for an encounter with Dr. Williams to see if she can be a donor.

2.6 Autologous Donation

Karl Thomson is going to have a surgery some time close in the future. Dr. Wilson has decided that Mr. Thompson is a potential candidate for an autologous donation. Mr. Thompson goes to the Blood Bank and is asked for his physician’s written approval, his demographics and will have to fill in the Blood Bank questionnaire as well. His IDs will be generated and all the written information has to specially identify him as an autologous donor. A blood sample will be taken to the lab for haematological tests and will wait for an encounter with Dr. Williams to see if he can be an autologous donor.

3 Eligibility Observation POBB_ST003000

3.1 Purpose

This storyboard considers the point in time where a physician evaluates the donor candidate as well as the results of the laboratory tests in order to determine whether he/she is eligible to donate blood or not. If it is available, the physician will review the HealthCare Record, to identify previous illnesses and confirm the information provided by the patient.

In case the donor is eligible, he/she has to sign a consent format which informs about the adverse events that could follow the process.

In case the donor is eligible but for a subsequent session, the physician will inform about a temporary deferral from routine donation.

In case the donor is not eligible, the physician will report it to the person’s record and will notify it to other Blood Banks in case he/she attempts to donate at another bank.

3.2 Eligibility Process

Dr. Wilson receives from the laboratory the tests results and has an encounter with Ms. Smith. He will evaluate the responses given by her in the questionnaire as well as her temperature, the skin at the venipuncture site, blood pressure and weight. Ms. Smith is healthy and covers all the requirements, so she signs the consent letter and goes to the waiting room to wait for the donation to start.

4 Donation Event POBB_ST005000

4.1 Purpose

This case covers all the possible information that can be reported while the donation takes place. This information contains data such as blood pressure, volume of blood drawn, duration of the bleed, adverse events and type of anticoagulant mixed with the whole blood.

After the recollection, the whole blood bag is delivered to the Blood Bank Laboratory for analysis and manufacturing. In case there was a problem with the blood bag, even though the donation was successful, the personnel are responsible for throwing it away and report it.

4.2 Donation Successful

Ms. Smith starts donating blood. The procedure finishes well. It does not exceed the limited time, the blood bag is on well condition, and volume of the blood bag has an allowed weight. After validating these instances, Nurse Johnson enters all this information to the system and delivers the whole blood bag to the Blood Bank Laboratory to analyze and manufacture it.

4.3 Donation Suspended

Ms. Smith starts donating blood, after 5 minutes she starts feeling dizzy until she faints. At that moment, Nurse Johnson stops the procedure and helps her to recover. Ms. Smith feels better and leaves the Blood Bank. Nurse Johnson throws away the blood bag as there was a trauma in the middle of the process and she reports it on the system.

5 Manufactured Blood POBB_ST006000

5.1 Purpose

The scope of this message is to report all the pertinent information regarding the blood’s manufacturing process. This includes which processes and what the products obtained from the whole blood are.

5.2 Manufacturing Process

Carlson, assistant of the Blood Bank, takes the blood bag, weights it and as it has an acceptable weight, it is put inside the machine and it is centrifuged to separate the whole blood into different blood components. The blood components will be washed, irradiated.

5.3 Post condition

Carlson has to report the results of the manufacturing process and verify that the sterile seal hasn’t breached at any time during the processing.

6 Blood Product Storage Process POBB_ST001000

6.1 Purpose

The purpose of this message is to inform to the system that a new product is stored at the stock and report information regarding the storage conditions such as temperature, expiration date. If the laboratory results haven’t been received at the storage department, it is required to identify that the product is on quarantine to ensure it cannot be released for use.

6.2 Blood Bank Stock Input

After manufacturing the whole blood, Carlson reports a bag with platelets has been stored at the incubator AB1 which is at 72ºF, a bag with plasma stored at freezer AB2 at 38ºF, and a bag with red blood cells at freezer AB2 at 34ºF.

6.3 Hospital’s Stock Input

Nurse James receives the products from Mr. Rogers, Blood Bank’s delivery man, she verifies that the bags are in good conditions and gives them an inventory number and stores them at the incubator or freezer respectively.

7 Blood Product Supply Request POBB_ST001010

7.1 Purpose

The purpose of this message is to identify the elements that have to be reported from System A to System B while requesting blood products to the Blood Bank. The Hospitals have to request to the Blood Bank a blood products stock for the day. It is considered the scheduled procedures and the transfusions that might occur. If there is an urgent request a higher priority is given during the delivery process.

7.2 Stock Request

At ABC Hospital, Nurse James reviews the surgeries agenda for tomorrow. There will be only one, Mr. Thompson’s and is programmed for tomorrow at 10am. She has been notified that he is an autologous donor so she summits a request to the Central Blood Bank. She asks for 5 O+ red blood cells bags, 10 platelets bags, 7 plasma bags and the whole blood bags from Mr. Thompson autologous donation. This request has to be fulfilled by tomorrow 6am.

8 Blood Product Supply Event POBB_ST001020

8.1 Purpose

The purpose of this message is to report all the required information involved on the process of distributing the blood products to the requestor Entity, which can be a Hospital, another Blood Bank or a specific Department inside the Hospital.

The Blood Bank notifies that the requested products are being sent. In case this particular Blood Bank lacks of a particular product can notify it directly to the Hospital and the Hospital will request it to other Blood Banks, or the Blood Bank will become the responsible for searching an existing product at the surrounding Blood Banks. Whenever the product is transport to the Hospital special conditions have to be adopted to keep it fresh and useful for transfusion purposes.

8.2 Stock Output

Central Blood Bank confirms to ABC Hospital the availability of the products requested (5 red blood cells bags, 10 platelets bags, 7 plasma bags and the whole blood bags from Mr. Thompson autologous donation). Carlson, the Blood Bank responsible, packs up the products in portable freezers and gives them to Mr. Rogers who will transport them to Children’s Hospital.

9 Transfusion Order POBB_ST008010

9.1 Purpose

The purpose of this message is to notify when and why a transfusion is required, as well as the blood products needed for this particular event. In case the patient was an autologous donor, it has to be notified in order to provide his/her blood previously stored.

9.2 Autologous Transfusion

Dr. Wilson has programmed Mr. Thompson’s surgery for tomorrow morning. His assistant notifies it to the Hospital’s Blood Bank to request the bags he donated at the Central Blood Bank.

9.3 Regular Transfusion

Mr. Johnson has been hospitalized for 2 days. He has anemia and Dr. Wilson has decided that he needs a transfusion. Dr. Wilson’s assistant notifies to the Hospital’s Blood Bank the need of 2 O+ units.

10 Transfusion Event POBB_ST008020

10.1 Purpose

The purpose of this message is to report the outcome of the transfusion process.

10.2 Transfusion Event

After finding the correct crossed match, the transfusion for Mr. Johnson is held. Dr. Wilson’s assistant reports everything that happens during the transfusion and if it was successful or not.

Relationships with Lab Pre-donation Screening exam Post-donation Hematology exam Pre-transfusion Cross Match exam