John C. Staley

Thanks for the responses.  I've discovered over the years that blood bankers love to live in the land of "What If".  You can be confident that I own a large home right in the middle of that land.    
 
I'm finding that patients are taking a more direct hand in their care and are much more knowledgeable than they were 30 years ago.  While info from a patient should be confirmed if possible, much more often than not they are reasonably correct if not complete in their info. 

Thanks for the responses.  I've discovered over the years that blood bankers love to live in the land of "What If".  You can be confident that I own a large home right in the middle of that land.    
 
I'm finding that patients are taking a more direct hand in their care and are much more knowledgeable than they were 30 years ago.  While info from a patient should be confirmed if possible, much more often than not they are reasonably correct if not complete in their info. 

EXACTLY! 

EXACTLY! 

Time for a little philosophy.  I have often described healthcare as an upside down pyramid with everything balanced on it's weakest part.  Generally speaking, and I really intend no disrespect here but, our entire system is at the mercy of the lowest paid, least educated areas with the highest turn over rate.  You will rarely encounter a career admissions clerk.  Their training generally consists of "see one, do one, teach one".  Granted this is based on my limited personal experience but it is what I and my wife have both seen in our careers in healthcare.  As to a solution, I'm sorry to say that I don't have one that is very palitable in the current climate of financial restraint.  (How is that for attempting to be PC!)  I have found over the years when ever the opportunity to educate those folks responsible for obtaining patient information on why it is so critical, from a blood bank perspective, to get it right they were quite surprised and became much more diligent.  Which brings me to another of my favorite axioms, "If they don't know why they can't or won't comply!"
 
Ok, I'm done.  Have a nice day. 

Time for a little philosophy.  I have often described healthcare as an upside down pyramid with everything balanced on it's weakest part.  Generally speaking, and I really intend no disrespect here but, our entire system is at the mercy of the lowest paid, least educated areas with the highest turn over rate.  You will rarely encounter a career admissions clerk.  Their training generally consists of "see one, do one, teach one".  Granted this is based on my limited personal experience but it is what I and my wife have both seen in our careers in healthcare.  As to a solution, I'm sorry to say that I don't have one that is very palitable in the current climate of financial restraint.  (How is that for attempting to be PC!)  I have found over the years when ever the opportunity to educate those folks responsible for obtaining patient information on why it is so critical, from a blood bank perspective, to get it right they were quite surprised and became much more diligent.  Which brings me to another of my favorite axioms, "If they don't know why they can't or won't comply!"
 
Ok, I'm done.  Have a nice day. 

Time for a little philosophy.  I have often described healthcare as an upside down pyramid with everything balanced on it's weakest part.  Generally speaking, and I really intend no disrespect here but, our entire system is at the mercy of the lowest paid, least educated areas with the highest turn over rate.  You will rarely encounter a career admissions clerk.  Their training generally consists of "see one, do one, teach one".  Granted this is based on my limited personal experience but it is what I and my wife have both seen in our careers in healthcare.  As to a solution, I'm sorry to say that I don't have one that is very palitable in the current climate of financial restraint.  (How is that for attempting to be PC!)  I have found over the years when ever the opportunity to educate those folks responsible for obtaining patient information on why it is so critical, from a blood bank perspective, to get it right they were quite surprised and became much more diligent.  Which brings me to another of my favorite axioms, "If they don't know why they can't or won't comply!"
 
Ok, I'm done.  Have a nice day. 

I'm reasonably certain that no one here is "saying there is no risk". What most of us are saying is that, often the risk to the individual trauma patient is much more academic than real. The real risk for most of us is not having the Rh negative blood for a patient that really NEEDS it because it all went to a patient who would have done just fine, ie survived, with Rh positive blood.
If you have the luxury of not having to worry about inventory levels of O Neg RBCs then more power to you. Most of us have not, do not and never will live in such an enviroment. We owe it to all of our patients to be the best stewards of the resource we can possibly be. We live in an imperfect world.
:juggle:

I agree entirely with those above.  This responsibility is not yours!!  A nurse should never request a blood product without personally seeing the order to transfuse.  It's simple enough that a college educated nurse should have no problem grasping the concept. 

Time for a little philosophy.  I have often described healthcare as an upside down pyramid with everything balanced on it's weakest part.  Generally speaking, and I really intend no disrespect here but, our entire system is at the mercy of the lowest paid, least educated areas with the highest turn over rate.  You will rarely encounter a career admissions clerk.  Their training generally consists of "see one, do one, teach one".  Granted this is based on my limited personal experience but it is what I and my wife have both seen in our careers in healthcare.  As to a solution, I'm sorry to say that I don't have one that is very palitable in the current climate of financial restraint.  (How is that for attempting to be PC!)  I have found over the years when ever the opportunity to educate those folks responsible for obtaining patient information on why it is so critical, from a blood bank perspective, to get it right they were quite surprised and became much more diligent.  Which brings me to another of my favorite axioms, "If they don't know why they can't or won't comply!"
 
Ok, I'm done.  Have a nice day. 

This is one more example of when I think I've "seen it all", some one comes along and shows me how wrong I was.  Frankly I'm surprised that a blood bank medical director would go along with this but then I've run across a few with the philosophy give the docs anything they asked for.
 
I just had another thought, what about the 6 patients who get those single donor units.  You are short changing them.  Kinda like watering down the whiskey in your bar to make more money!
 

I agree entirely with those above.  This responsibility is not yours!!  A nurse should never request a blood product without personally seeing the order to transfuse.  It's simple enough that a college educated nurse should have no problem grasping the concept. 

Time for a little philosophy.  I have often described healthcare as an upside down pyramid with everything balanced on it's weakest part.  Generally speaking, and I really intend no disrespect here but, our entire system is at the mercy of the lowest paid, least educated areas with the highest turn over rate.  You will rarely encounter a career admissions clerk.  Their training generally consists of "see one, do one, teach one".  Granted this is based on my limited personal experience but it is what I and my wife have both seen in our careers in healthcare.  As to a solution, I'm sorry to say that I don't have one that is very palitable in the current climate of financial restraint.  (How is that for attempting to be PC!)  I have found over the years when ever the opportunity to educate those folks responsible for obtaining patient information on why it is so critical, from a blood bank perspective, to get it right they were quite surprised and became much more diligent.  Which brings me to another of my favorite axioms, "If they don't know why they can't or won't comply!"
 
Ok, I'm done.  Have a nice day. 

This is one more example of when I think I've "seen it all", some one comes along and shows me how wrong I was.  Frankly I'm surprised that a blood bank medical director would go along with this but then I've run across a few with the philosophy give the docs anything they asked for.
 
I just had another thought, what about the 6 patients who get those single donor units.  You are short changing them.  Kinda like watering down the whiskey in your bar to make more money!
 

One other attribute of QC I didn't see mentioned. You are also QC'ing the user. Is the staff performing the testing correctly? There is more to the testing than just the reagents being functional. Therefore, I see the need for QC of all methods in use at least once each day of use.

Time for a little philosophy.  I have often described healthcare as an upside down pyramid with everything balanced on it's weakest part.  Generally speaking, and I really intend no disrespect here but, our entire system is at the mercy of the lowest paid, least educated areas with the highest turn over rate.  You will rarely encounter a career admissions clerk.  Their training generally consists of "see one, do one, teach one".  Granted this is based on my limited personal experience but it is what I and my wife have both seen in our careers in healthcare.  As to a solution, I'm sorry to say that I don't have one that is very palitable in the current climate of financial restraint.  (How is that for attempting to be PC!)  I have found over the years when ever the opportunity to educate those folks responsible for obtaining patient information on why it is so critical, from a blood bank perspective, to get it right they were quite surprised and became much more diligent.  Which brings me to another of my favorite axioms, "If they don't know why they can't or won't comply!"
 
Ok, I'm done.  Have a nice day. 

Generally speaking they can interface anything if you have the money to spend and it can be very expensive.  Good luck because a good interface is usually money well spent. 

Unless something has changed recently which I am not aware of, (the amount of info that changes daily that I am not aware of is truly staggering) a FDA inspector would be very unlikely to consider your use of coolers as transport.  They would be more likely to consider them storage and therefore insist on a storage temp range of 1 - 6 oC.  Especially since the blood is not packed by you and does not leave the blood bank in the coolers. 

Time for a little philosophy.  I have often described healthcare as an upside down pyramid with everything balanced on it's weakest part.  Generally speaking, and I really intend no disrespect here but, our entire system is at the mercy of the lowest paid, least educated areas with the highest turn over rate.  You will rarely encounter a career admissions clerk.  Their training generally consists of "see one, do one, teach one".  Granted this is based on my limited personal experience but it is what I and my wife have both seen in our careers in healthcare.  As to a solution, I'm sorry to say that I don't have one that is very palitable in the current climate of financial restraint.  (How is that for attempting to be PC!)  I have found over the years when ever the opportunity to educate those folks responsible for obtaining patient information on why it is so critical, from a blood bank perspective, to get it right they were quite surprised and became much more diligent.  Which brings me to another of my favorite axioms, "If they don't know why they can't or won't comply!"
 
Ok, I'm done.  Have a nice day. 

Time for a little philosophy.  I have often described healthcare as an upside down pyramid with everything balanced on it's weakest part.  Generally speaking, and I really intend no disrespect here but, our entire system is at the mercy of the lowest paid, least educated areas with the highest turn over rate.  You will rarely encounter a career admissions clerk.  Their training generally consists of "see one, do one, teach one".  Granted this is based on my limited personal experience but it is what I and my wife have both seen in our careers in healthcare.  As to a solution, I'm sorry to say that I don't have one that is very palitable in the current climate of financial restraint.  (How is that for attempting to be PC!)  I have found over the years when ever the opportunity to educate those folks responsible for obtaining patient information on why it is so critical, from a blood bank perspective, to get it right they were quite surprised and became much more diligent.  Which brings me to another of my favorite axioms, "If they don't know why they can't or won't comply!"
 
Ok, I'm done.  Have a nice day. 

Time for a little philosophy.  I have often described healthcare as an upside down pyramid with everything balanced on it's weakest part.  Generally speaking, and I really intend no disrespect here but, our entire system is at the mercy of the lowest paid, least educated areas with the highest turn over rate.  You will rarely encounter a career admissions clerk.  Their training generally consists of "see one, do one, teach one".  Granted this is based on my limited personal experience but it is what I and my wife have both seen in our careers in healthcare.  As to a solution, I'm sorry to say that I don't have one that is very palitable in the current climate of financial restraint.  (How is that for attempting to be PC!)  I have found over the years when ever the opportunity to educate those folks responsible for obtaining patient information on why it is so critical, from a blood bank perspective, to get it right they were quite surprised and became much more diligent.  Which brings me to another of my favorite axioms, "If they don't know why they can't or won't comply!"
 
Ok, I'm done.  Have a nice day. 

Considering the speed of transport, we stopped sending coolers to the OR when we started sending blood in the pneumatic tube.  There is really no good reason to have blood setting in a cooler in the OR when the time lapse between request and arrival can be measured in seconds.  The problem is convincing the docs to give up their security blanket.  Our tube system was rated for upto 7 lbs which meant we could send upto 4 units of PRBCs in one tube.  I failed to mention this to nurses.  They didn't need to know!   

Time for a little philosophy.  I have often described healthcare as an upside down pyramid with everything balanced on it's weakest part.  Generally speaking, and I really intend no disrespect here but, our entire system is at the mercy of the lowest paid, least educated areas with the highest turn over rate.  You will rarely encounter a career admissions clerk.  Their training generally consists of "see one, do one, teach one".  Granted this is based on my limited personal experience but it is what I and my wife have both seen in our careers in healthcare.  As to a solution, I'm sorry to say that I don't have one that is very palitable in the current climate of financial restraint.  (How is that for attempting to be PC!)  I have found over the years when ever the opportunity to educate those folks responsible for obtaining patient information on why it is so critical, from a blood bank perspective, to get it right they were quite surprised and became much more diligent.  Which brings me to another of my favorite axioms, "If they don't know why they can't or won't comply!"
 
Ok, I'm done.  Have a nice day. 

Time for a little philosophy.  I have often described healthcare as an upside down pyramid with everything balanced on it's weakest part.  Generally speaking, and I really intend no disrespect here but, our entire system is at the mercy of the lowest paid, least educated areas with the highest turn over rate.  You will rarely encounter a career admissions clerk.  Their training generally consists of "see one, do one, teach one".  Granted this is based on my limited personal experience but it is what I and my wife have both seen in our careers in healthcare.  As to a solution, I'm sorry to say that I don't have one that is very palitable in the current climate of financial restraint.  (How is that for attempting to be PC!)  I have found over the years when ever the opportunity to educate those folks responsible for obtaining patient information on why it is so critical, from a blood bank perspective, to get it right they were quite surprised and became much more diligent.  Which brings me to another of my favorite axioms, "If they don't know why they can't or won't comply!"
 
Ok, I'm done.  Have a nice day. 

Interesting how somethings just resist change no matter how hard we try. It is a very difficult mind set to overcome that errors and mistakes must result in punishment. Most of the above comments come from very enlightened folks but there are still far more out there in positions of authority that are not so enlightened. (one of the primary reasons I left my previous employment but that is a story for another time) Over the years I found that by getting my staff actively involved in the root cause analysis and the corrective action they were able to come around to the idea that the goal was process improvement and not punishment. They became aware of the "down stream consequences" of errors and became active in helping fix any problems. I emphasized that since they were the ones doing the work they needed to be the ones to identify where corrective action was needed. This did not happen over night but as the culture slowly changed and new staff came on board I could actually see the culture changing. Patience is the key.
Wow, that's awful long winded for me. Just keep working at it and setting the example, those willing will follow, the rest will be left behind.