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The Final Check: Blood Specimen Mislabeling Solution
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- Project Overview
- The Final Check reduced mislabeled blood specimens by over 90%
- Project started at Palmetto Health Richland Hospital in South Carolina
- Five additional hospitals adopted the intervention
- The intervention is now free of charge
- Key Interventions
- The Final Check involves verbal confirmation of last three digits of medical record number
- The check was developed through a socio-technical probabilistic risk assessment
- The model predicted a 98% reduction in mislabeled specimens
- The check was designed to minimize process variation despite disciplinary threats
- Implementation Principles
- The Final Check must be implemented within a Just Culture framework
- Staff must be held accountable for compliance
- Red-Rule disciplinary practices should be reversed
- Non-value-added steps should be eliminated
- Staff should be encouraged to report errors at bedside
- Implementation Process
- Assessment of current labeling procedure required
- Staff training and demonstration of the check
- Managers should monitor compliance
- Learning culture should be created around mislabeling
- Community resources available for implementation guidance