Extended phlebotomy service

Leeds Teaching Hospitals NHS Trust (LTHT) has five hospital sites. Every week the phlebotomy team sees an average of 10,000 patients across those sites.

Facing increasing demand, the phlebotomy service has introduced changes that:

• provide a cannulation service
• provide a timelier service, improving test to treatment timeline
• take some pressure off doctors and nurses on acute wards
• improve patient flow in the hospital

Phlebotomists used to visit acute ESM wards for four hours on weekday mornings. They provided a very limited service at the weekends. Clinicians made paper blood requests to the team. The phlebotomy service did not include cannulation. This could result in delays to taking blood tests, receiving results, and beginning treatment. Nurses and doctors spent a lot of their time performing these tasks.

From pilot to business as usual

The phlebotomy team offered to extend their service to one CSU. This short-term extension would support winter planning.

Phlebotomists were based in the Emergency and Speciality Medicine CSU. The service became available from 8am to 8pm, 7 days a week. It provided both venepuncture and cannulation services.

This pilot was successful and has now become business as usual.

The phlebotomy team carries out venepuncture and cannulation. This releases medical and nursing teams to deliver more appropriate care to patients.

Achievements

In one week during the pilot, phlebotomists inserted 68 cannulas. This equated to approximately 25 hours 40 minutes of doctors’ time.

A further 11 hours 30 minutes of doctors’ and nurses’ time was saved through not having to take blood samples.

Further improvements

Introducing an electronic ordering system reduced the risk of repeat requesting and re-testing. Thus the patient experience was improved and unnecessary costs reduced.

The team planned to use this model at Leeds Children’s Hospital. But there were some challenges. Cannulating sick children in an acute setting was a particular challenge. So the team recognised that further work with the children’s hospital would be required.

The team now provides expert venepuncture services in a bespoke children’s blood room. This is a more appropriate setting to care for children with the support of play specialists. The phlebotomy team also provides a daily service to children’s wards.

LTHT are currently rolling out phlebotomy e-trolleys across the Trust. The ultimate goal is to roll out a more bespoke phlebotomy service - mirroring the above model across all CSUs at LTHT.