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Posts posted by Likewine99
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I agree with Jessica A, With a downstream BB system (SoftBank, Cerner, WellSky etc) you shouldn't need to check EPIC for previous pt history, that should be in your converted data from your old system. That you would have validated prior to your SoftBank go live.
I worked with 14 Blood Banks with converted data from 3 legacy systems. None of them used EPIC as a source for previous patient history. Aren't your patient historical results in SoftBank?
Just curious why you would import historical BB data into EPIC? Our Medical Records department was responsible for patient data converted into EPIC but BB data source of truth was always the BB system.
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If you have the IT department do the validation make sure they are blood bankers, or at least understand exactly what you are validating. I've done this twice in my career. I took several of my frequent flyers that had multiple antibodies, some of our patients that had previous antibodies but currently showed negative screens and those patients with "odd special needs" i.e. things outside the usual antibody problems.
Like Banker Girl I did 10% of the total converted records, yes that is a lot of pts in a big data base, but as you do your validation you will get comfortable with the converted data in the new system.
We also did more than one pass of converted data. Checked the first vendor extract, found some "misses", they re-coded the extract, checked the second pass, etc. By the time we made it to go live the data was clean. We did have to have some "comments" in the new system as it's hard to map like for like especially with special instruction.
Key point is to make sure you have good documentation for when your assessors and inspectors show up. I've been asked on more than one occasion to provide the data conversion validation documentation.
Good luck and have fun
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I understand David's point and agree 100000%. Having worked in 50 bed, 500 bed and 1200 bed hospitals and hospitals in small towns, suburbia, and big university medical centers, blood suppliers DO NOT understand the smaller places that can go days without transfusing.
It is everyone's responsibility to be good stewards of this very precious resource. Inventory management from the supplier level down to the techs in the blood banks is critical to making sure every patient everywhere can get what they need as quickly as possible.
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Nurses performing ABO/Rh testing, scary. AMcCord and R1R2.
- AMcCord, ADawson and Malcolm Needs
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Welcome, lots of good info on this site
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Welcome! You will love this site
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Stat Spin is the way to go. I've validated them at a previous job and based on 3 min and 4000g we checked specimens to make sure the plasma was plt poor. A shorter spin time will most definitely lower your TATs and help with workflows too.
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tcoyle makes an excellent point, your vendor may stop supporting your version if you don't take the recommended upgrades. I support 14 hospital BBs and I know upgrading and validating is expensive. There are reasons software is updated, your lab director or IT department needs to allocate funds to get this done for you, tie it to patient safety!
I don't know of any mandatory FDA reg that says you must update but it's just like running your car, it needs maintenance if it is to perform well.
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I just answered this question.
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My ScoreFAIL
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Could it be something stronger than coffee?? But coffee is good too!!
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As everyone else said, document, document, document. This person is a huge risk to patient safety which should send up red flags to everyone and it's also a risk to your hospital to have someone of this caliber in your lab.
Do you have an HR counseling policy, I've used it to document unsatisfactory technical performance or a violation of organizational values and mission. Start with a verbal warning/discussion. "No you may not do a DAT test without having your competency signed off". After the verbal (document this) then take it to a level I (or whatever your HR calls it), refusing to follow policy and procedure, unsafe patient care, tie this to something in the counseling framework. Get input from HR with this.
At the time of the Level I, reiterate that if this behavior is observed again this will take the counseling to a Level II. At this point the tech may need to go on a "highly structured performance improvement plan" which I've seen done in conjunction with the employee. Goals are set, timeframe for touch base meetings set, feed back sessions on progress. You are giving them the benefit of the doubt and this is fair to the employee in question.
Usually if the performance improvement goals aren't met, bye bye, adios, das veydanya. You can't do this alone, you need upper management and HR involvement because this could become quite unpleasant for everyone involved. Especially a patient.
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Physician responsibility.
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What is your site currently doing for the blood product transfusion tag? We are getting ready to change ours and are looking for suggestions to meet all accrediting agencies requirements. Thanks.
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I just answered this question.
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My ScoreFAIL
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Level II, 20 min from supplier, 2 plts for stock
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When your lab goes to Beaker your BB system will be interfaced, regardless of which system you decide to go with. My organization has 16 labs on Beaker with HCLL Blood Bank. We sunsetted Meditech, Cerner, McKesson and Sunquest lab/BB systems and all of the labs are on Beaker and HCLL.
Being downstream from Beaker you will want to become best friends with your Epic interface analyst as there is always some gymnastics that need to occur with any BB system to get it to talk to Epic and Beaker.
After bringing up these 16 sites we learned quite a bit and with our last Epic 2015 upgrade and HCLL Maestro interface upgrade we are at a very steady state.
Don't forget you will want to look at the Blood Product Administration workflow, again, regardless of the BB vendor you choose.
If you have more specific questions PM or email me, Mary.Mendel@Mercy.Net
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Dan87 do you get reimbursed for all of this "extra work"?
I haven't done complete XMs since the early 1990s and have worked in a variety of places, large, small, adult, pediatric.
Change is hard but it really is time to drop the "unnecessary" testing, imho!
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I agree with jalomahe, why in the heck does your IT department care about a PC that is attached to an analyzer? I'm sure it is the fact that they don't understand it is part of the analyzer and will only transmit info to the LIS. And they may consider this part of the hospital network.
It might be a tough sell to get IT to let you purchase this analyzer, network security, viruses, firewalls all that technical stuff is front and center in their minds, they are most likely technical and not clinical.
What about other analyzers in your lab, what platform do they run on? Of course IT would probably say these were grandfathered in if they are not on Windows 7 and they are OK.
You gotta wonder what Immucor is thinking since the Griffols, BioRad and Ortho analyzers are on W7.
Sorry to hear this, it is always something isn't it????
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Our BB system, HCLL, prints a single sheet, 8.5 x 11 transfusion slip which has a sticky label as part of the slip.
We remove the sticky label, place it on a "toe tag" and use the plastic loop-tee-loo things to attach to the blood bag.
The paper does not accompany the unit most of the time, we are on Epic and tx documentation occurs there.
We only use the paper if we are in a downtime situation, or blood is going to an offsite location or the transfusionist is not able to document in Epic.
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Pool before issue
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Not doing this. Wow you must have a ton of time on your hands, just kidding!!
And do you get paid for this "meaningless" work. If you can document pt had Rhogam administration you need to get your pathologist to stop this, it's crazy I tell you.
What value does this add to the patient??
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Still doing IgG crossmatches but they are on an analyzer so that helps.
HEMATRAX PRINTER VALIDATION
in Computer Systems / Software / ISBT128
Posted
We had a site that needed to do this and they wrote a simple validation plan and worked with the local site support team on the install. Once it was delivered the local site support person worked with the vendor, there was some software that needed to be loaded from Hematrax (not sure what that was). He was also responsible for all the network connections and anything hardware related.
He then did a factory "calibration" to make sure the printer actually printed something. I think the printer may have spit out some labels, I supported remotely so I wasn't onsite when the desktop guy did that part.
The Blood Bank manager then did some thawing and splitting "for real" as this was set up on a production server. It was a high volume place so none of the products would have gone to waste.
The manager did what she felt was applicable to the site, she printed duplicate labels on the products so there was documentation that the labels printed correctly. They also captured screen shots from the BB system to provide documentation that nothing was affected with the actual application.
Maybe someone closer to the front lines has done something similar but our site had no problems with the validation plan and documentation when all of the acronym accreditation agencies showed up on her door step.