Efficiency and safety gains from bedside electronic transfusion checks in four hospitals in England.

Bedside electronic transfusion check (BETC) systems support safer practice by aiding staff in patient identification during group and screen (G&S) sample labelling and blood component administration, steps where most transfusion errors occur. While the safety rationale is clear, the significant costs necessitate robust cost-benefit evaluation. During phased BETC implementation in four London hospitals, we mapped in detail transfusion workflow, quantifying staff time saved under three modes of technology adoption which enable three corresponding states of organisational use: Mode-A (baseline: manual-only); Mode-B (partial technology-capability implementation, mixed coverage and staff uptake); and Mode-C (full implementation, wide coverage and 100% uptake). Benefits depend on implementation mode and uptake. Across the whole transfusion pathway, estimated staff-time saved per blood unit (including fewer G&S) was 9.3 min (20% reduction) under Mode-B and 17.3 min (38%) under Mode-C compared with baseline. Estimated annual time savings across the four hospitals were 8950 h (Mode-B) and 16 650 h (Mode-C), including fewer G&S samples (3800 Mode-B; 26 950 Mode-C) because of fewer rejections with BETC and the potential to remove the second G&S sample policy under Mode-C. BETC also substantially improved staff compliance with safety protocols. Overall, BETC can deliver significant efficiency gains alongside safety improvements, supporting the case for wider adoption.