Misfiling
If your lab uses a card file to track patient blood bank history, some cards are misfiled. Depending on where in the file they are placed, they may be good as gone. A blood banker won't be able to compare blood types or know that the patient has a positive antibody history. And for your patients, this can be fatal.
How many cards are misfiled? One source cites this example: a rate of one-half of one percent in a central storage area of twenty five filing cabinets means one thousand records are misfiled. Actual rates may be as high as one to ten percent in office environments. In a blood bank, of course, it only takes one misfiled card to cause a sentinel event.
This suggests that professionals are less likely to misfile. (Our laboratory discovered a 0.2% misfiling rate.) But handwritten cards are difficult to read, clumsy to thumb through, easy to stick together, and sometimes "lost" in temporary piles. Even if periodically checked for accuracy, manual filing is time-consuming and error-prone.
Blood bank information systems are summarized here. It may worth adding to a wish list, depending on the size of your laboratory and its priorities. In the meantime, what can be done?
Conceptually, a misfiled card is an indexing problem. Your card file is in alphabetical order, and if a card is not in a correct place it is out of the index i.e. lost. Because items – the cards – are constantly removed and replaced in this index, this data structure is easily corrupted. When that happens, the only real solution is to "rebuild" the index by re-alphabetizing all the cards. Ugh!
One simple solution is a mirror index – a list of all the cards (name and date of birth) in the card file – in database software such as Microsoft Access. Add a new card in the file, add a new entry in the database. Software won't misfile the name and be a reliable backup. It will tell you that a card exists even if it is misfiled, making your blood bank (and patients) safer.