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Posts posted by Likewine99
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We just went live last Wed with HCLL (old Hemocare users) and converted 15 years worth of data.
We selected 5 patients all with multiple antibodies and special needs and when we received our initial converted data, about 3 months before go live they were all there.
Then we randomly selected 100 patients and reviewed everything from ABO/Rh, XM, special instructions, etc and verified that what we had in the old system, i.e. 2+, 3+, comp, that kind of thing transferred over.
The day of go live, when we first had access to the converted data, I checked those initial 5 patients with all of the abs and special instructions and verified that the results were still like they were with the first data conversion check.
On go live day you'll only have enough time to check your abnormal patients or whatever you decide to check to verify that the final data conversion was successful. Once your interface is working the fun starts!
As time permits we will recheck those 100 other patients.
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We are a 400 bed, Level II trauma center and do not scope tube ab procedures. If we do a tube ab scren or panel we use LISS.
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Call the vendor and explain your problem. Ask them to come out and give the nsg staff an inservice on how to use them.
Tell them you may have to look at another vendor since their product is not working well and you are losing $$$ when units are wasted.
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Our network trauma team devised our massive tx protocol, based on literature they reviewed relating to trauma. It lays out the guidelines as to what tests to be done after units of RBC's, FFP, and plts are given.
BB keeps track of what has been given and notifies ED/OR/ICU of which labs to draw. We haven't been asked to retrospectively monitor this, it only happens about 3 or 4 times a year at our place.
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I keep the QA forms that come with them and when I do the yearly cooler validations I put them on the units that are in the cooler. I validate my coolers for 8 hours since they are only used to take blood to the ED for traumas.
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Has anyone worked on interfacing the ProVue to HCLL?
We are scheduled to go live in 2 weeks with version 2.9.3 and by mid-October I would like to begin the interface build for ProVue to HCLL.
Any help or suggestions GREATLY appreciated. Thanks!
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I have successfully built a daily QC rack for MTS gel and tube reagents. We are going live with HCLL on 9/16 and this rack works well for us.
My work e-mail is Mary_Mendel@ssmhc.com
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Our pts only get elutions when the autocontrol is pos on a panel AND the pt has been tx in the last 21 days.
I've had docs ask for this and invariably the elution is neg. We use gel for our panels/autocontrols.
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We use ProVue, back it up with manual gel at the bench. We do panels on the PV and have had great luck with it. Live 2 years this May, will be interfacing to HCLL after our Sept go-live.
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Worked for me with Office 2003
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We validate our coolers once a year, use Safe-T-Vue indicators on units going into the cooler. Like pamann I keep the sheet that comes with the indicators. If I'm the validator do I have to be validated too?????
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Anti-D with donor cells is easy, I've also used expired check cells. NedB you are correct to think that "main lab" people will be working in the BB in the future. Of the 20 techs I have that rotate through BB, only 1 is an SBB and dedicated and everyone else works 2 and often 3 other spots and some are PRN.
The anti-D eluate is clear cut and boosts their confidence level.
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We also use an outside source and they do the same, charge extra for w/e and stats. I am not aware of a CPT code that covers the stat fee, we just absorb it as directed by our "billing gurus" in the finance dept.
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Lara,
I am currently using my lab general QM, if I could get a copy of yours for BB I have until next spring to get it ready. Thank you. Thank you.
e-mail to Mary_Mendel@ssmhc.com
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We've worked with our blood supplier and had our physician peer review committees educate physicians on the practice of moving away from auto units.
We tied it to dollars that are not recoverable when the unit is not used, we don't draw them at our place, the 6 we've had so far this year were drawn by ARC and 5 were given.
If a doc requested autos or directeds our med dir sent a letter asking why?
Soooo glad we've moved away from this! Huge cost savings not couting the time:highfive:
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Physician engagement it the key to this. As David mentioned the peer review process is a good way to have docs evaluate tx practices.
Our tx committee consists of our Medical Director, hospital VP of Med Affairs, and one other doc. I've found that if physicians drive the committee you have a much better chance of success.
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We follow a similar scenario and if an XM is ordered the pre-op staff orders it at the time the pre-op sample is drawn.
The day before the surgery we XM the blood, we have the bar code label for the order in the BB and the test hangs out on our incomplete worklist so we don't miss it on the day of surgery. Our samples follow the same 14 day rules.
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rcurrie I agree that we should point fingers, especially when someone from outside the lab collects a specimen.
The problem we were having was that our lab staff was entering external comments, which appears on the pt MR, and they weren't worded as professionally as they could have been.
We do place the blame squarely on the nursing staff but we are trying to get away from sniping at them through an external comment.
We are also trying to zero in on specific individuals who may not be following specific collection guidelines, but we have over 600 people in our hospital that collect samples and it's nearly impossible to keep track of it.
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:clap:Thank you bbkdiane, very well put and great idea on the legal ramifications to patient safety.
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Welcome! This is a great site and with your experience in Ref Lab mabye you can share your knowledge with those of us who usually send out the hard stuff.
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We do a similar appended report with verbiage that says "the above results do not belong to this patient". We are trying to keep the free texting standard and not point fingers at nsg staff.
We then fill out a hosptial occurrence report that goes to the Registration Director and into the hospital risk mgt database. We also have our own lab QA internal database and we code the QA's based on pre, post and analytical errors, wrong reg is one of the choices. We also do a verbal report and treat it like a critical value. Too much work, too many forms:cries:
As far as addressing and doing something about them we fall a little short here, it's an ugly mess and we are still trying to work out the kinks
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I think your auditor may be correct. We do not bill patients for sickle cell tesing on units. I did a stint as a Chargemaster Coordinator for about a year and I think the billing people would say that the sickle cell testing is "part of the procedure" in getting the units ready for the pt.
Maybe you could set up a $0.0 charge to at least get the workload credit for doing the test.
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We do not QC panels, we d/c'd that about 10 years ago. We QC the gel cards that are used to perform the panel and we QC the screening cells that were used that gave the pos absc.
The theory here is that the panel is an "extended ab screen" and you are using it to "confirm" what was suggested in the absc.
If any of the compliance gurus in the group think that my organization should revisit this pls let me know, we are CAP accredited but not AABB.
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We use 50 mL sterile saline that we get from Central Supply. Cost is 35 cents a bag, our computer system has a place in the pooling procedure to record lot numbers.
Platelet products out of blood bank
in Education / Quality
Posted
We stick with the 30 minute rule to keep it standard for all products so that the nsg staff doesn't get confused.
We are especially picky with the OR since we have have had plts come back in the portable refrig!