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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