11 February 2022 (Friday) - Do I Have To?

Regular readers of this drivel may recall that a few days ago I wondered how I might improve the quality of my practice and service delivery. Here’s a thought that I had…

Back when I started in this game (when dinosaurs walked the Earth) a full blood count gave you seven parameters. Wbc, Rbc, Hb, MCT, MCV, MCH, MCHC. If you wanted a platelet count that was on another machine, and a white cell differential and blood film morphology was down a microscope.Nowadays the blood count gives you a platelet count, differential white cell count and a pretty decent overview of the blood cells morphology too.
But the terminology used by many of the medics remains what it was. And for many laboratories “FBC and diff” means looking at a (probably) utterly unnecessary and redundant blood film.

I can’t help but think that if we need to look at a blood film (apart from looking for parasites), the modern analyser will tell us. However many laboratories will look at a blood film if a request to do so is made… even though the requestor is probably unaware of what the modern analysers can do.
If we make the decision that we use the analysers for the purpose for which we bought them and only look at those blood films that actually need looking at we can eliminate a sizeable and utterly unnecessary part of our workload; freeing up staff to look at that which needs looking at, and not at that which doesn’t.

 Before going to bother the boss with this idea I thought I might ask the question of the Facebook Hematology Interest Group. After three days it seemed that the vast majority of people replying agreed with me. Several felt that if a doctor asked for blood film scrutiny then we should look at a blood film, but not one seemed to be able to justify this position.
I’ll bring this up at the next quality meeting…

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