ISBT 128 Survey

In July 2005, AABB  conducted a survey to gauge progress in the implementation of ISBT 128. A total of 529 facilities, including blood centers, hospital blood banks, and transfusion services, responded. Some of the participating facilities chose not to answer every question on the survey. As a result, the number of responses varies from one question to the next. Therefore, results are reported as numbers rather than in percentages.

Of the 529 facilities that responded to the survey, 463 identified their facility type. The breakdown was as follows:

• 54 blood centers
• 173 hospital blood banks
• 214 transfusion services
• 6 cellular therapy facilities
• 16 self-identified as other

Of the respondents, 30 (5.7%) have implemented ISBT 128. Their experiences include the following:

• Representatives of 11 facilities reported finding no major obstacles during the implementation.
• Of the facilities that encountered obstacles during the implementation, the most frequent logistical and operational obstacles involved the compatibility of existing software and hardware with the scanning/reading and printing of ISBT 128 labels. Another obstacle was the coordination of ISBT 128 implementation with a facility’s suppliers and customers.
• The most frequent administrative obstacles included validation of ISBT 128 and other related change control issues, including resources (allocating human resources needed to build computer tables, managing competing priorities, training staff, and updating the computer software).
• Seventeen of the facilities had a written plan for implementation of ISBT 128.
• One facility required more than 18 months to implement ISBT 128; 14 facilities completed implementation in less than 6 months.
• All 11 of the facilities that used the AABB ISBT 128 implementation plan (on the AABB Web site) found the plan useful.

Among the 499 facilities that have not implemented ISBT 128, the following findings are significant:

• Although 158 facilities plan to implement ISBT 128 within two years, 298 facilities were uncertain as to when they would implement ISBT 128.
• Among hospital based facilities, 405 of the facilities surveyed have a blood bank computer system. Among those facilities, 318 have computer systems that are compatible with ISBT 128.
• Although 77 facilities reported having budgeted for the cost of implementing ISBT 128, 267 have not. An additional 113 facility representatives did not know whether this cost was budgeted or not.
• When asked about implementation plans, 258 facilities indicated that their biggest obstacle in the eventual implementation of ISBT 128 is expected to be validation and other related change control issues (including resources and training). Another 223 facilities indicated their major obstacle would be blood supplier not ready.

Transitional Phase and Implementation
Survey responses also indicated quite clearly that additional written materials should be provided by AABB to assist with the implementation. The BB/TS SPU, the CT SPU, and the Information Systems Committee will endeavor to develop guidance geared toward different implementation scenarios. Guidance on compliance with AABB standards will continue to be published in Standards Source. The BB/TS SPU and the CT SPU will develop examples of how to satisfy the requirement for a written plan for implementation that will be published in Standards Source. AABB members are encouraged to begin this planning phase with the following initial steps in mind:

1) Develop an internal timeline for implementation of ISBT 128.
2) Review the bag labeling changes with transfusion service personnel and information systems staff.
3) Generate staff training schedules (to include staff and clinicians administering blood components and cellular therapy products).
4) Revise forms to accommodate a longer number.
5) Evaluate the need for information systems support and modifications.
6) Assess the ability of current bar code scanners to read (and the computer systems to interpret) ISBT 128 bar code labels.