Illustration of the Financial Impact of Usage of Initial Specimen Diversion Devices (ISDD) or Continued Educational Initiatives on the Costs from Blood Culture Contamination

Abstract Introduction/Objective Blood culture contamination (BCC) has the potential to lead to additional healthcare system costs and harm to patient. Two ways to reduce BCC have been explored in the literature and are economically modeled including initial specimen diversion devices (ISDD) and continued education on phlebotomy. Methods/Case Report A literature review on the economic costs of BCC, ISDD efficacy, and phlebotomy education to reduce BCC rates was undertaken. The reported average BCC at a veteran affairs medical center (VAMC), its reported rate during a month of phlebotomy training, the cost of an ISDD device at VAMC, and the average wage for 4 hours of phlebotomy manager time for training was noted. An illustrative economic model involving 100 patients was used at BCC rates of 1%, 2%, and 3% along with what had been observed at the VAMC was used for economic modeling. Results (if a Case Study enter NA) It was previously reported by Skoglund et al that in laboratories with rapid diagnostic testing modalities (such as MALDI-TOF or PCR testing), the cost per BCC event is $13,026 versus $8,287 in costs for a negative blood culture. ISDD efficacy in the literature reviewed (74.1% to 87.5%), continuous education efficacy (16.2% to 57.8%), ISDD device cost ($17.70 per device), and the hourly wage of a phlebotomy supervisor ($29.34) were noted. The reported average BCC rate from a regional VAMC was 1.33%, and during the month with education, the rate was 0.5%. From a model of 100 patients, ISDD device savings ranged from $1,741.60-$2,376.63 (1% BCR), $5,253.20-$6,523.25 (2% BCR), and $8,764.79-$10,669.88 (3% BCR). Education savings ranged from $755.98-$2,727.41 (1% BCR), $1,523.70-5,466.55 (2% BCR), and $2,291.42-$8,205.69 (3% BCR). The observed impact of education at the regional VAMC would have resulted in savings of $650.83 per 100 patients. Conclusion Both education and ISDD devices can result in significant savings from the costs of BCC.