On Monday, we upgraded our laboratory to ISBT128 labels. As indicated in our implementation plan, this is the first phase in our conversion to the new standard, and we learned quite a bit that will ease later phases next year.

We've allocated three different FINs to our donor and laboratory samples. This allows us to easily segregate tubes into their respective testing profiles and simplifies reporting. The three FINs are used to distinguish donor samples, cord blood samples (from the cord itself) and laboratory samples for ad hoc testing.

I believe we are the only blood center that is using the flag characters for production control. For example, we've used 31-34 on our donor samples, but we don't assume a particular flag is on a particular tube. We associate each tube (via DIN/flag tuple) with a tube definition (e.g. 5ml red top) during a process we call "sample entry." Every tube that enters the lab goes through this program. Once we have these data, we can uniquely identify every tube that enter the lab, and we are able to verify that the proper tube (and anticoagulant or additive) was used for each test. Since four tubes are collected from each donor, we know early in the process if an incomplete set of tubes was received. Later, we can run reports to identify any tests that may have been performed against an invalid tube. We hope to extend this concept into our component production process to allow us to uniquely identify each container that is used in the processing of a blood donation.

Our upgrade wasn't nearly as smooth as we had anticipated and caused a number of delays in posting laboratory results, but the rough spot is now behind us and we can redouble our efforts to roll ISBT128 out to the rest of our system.