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We are planning to hold a Quality week/ month to help our staff develop a better understanding of the quality system. I'm sure many folks on BBT have held similar events Please could you share the way you approached organising this ,with emphasis on what your staff really enjoyed , and also the more unsuccessful approach. thank you.
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Hi tonz, my place is not fully 5S but we began by clearing old files, equipment etc. Standardised folders for equipment management, training, SOPs- so they were all in visual colour groups. We have schedules and checklists for maintenance, cleaning, calibration, training etc. None of this is rocket science- just basic common sense and very easy to do, with a bit of teamwork and lean-thinking. Hope the ppt is useful- some feedback on improving it would be good. many thanks.
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Hi tonz, I have sent you a message. The ppt is probably too large to attach to this site- unless Cliff could manage to attach this?
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Thanks guys!!.....one has to consider these things sometimes you know eric.....nice to hear from you again, got anymore tips on 5S? Malcolm, really, it was restraint on my part that's why it took 8mths to post. Anyway, to update, there seems to be a lack of commitment with general tidying/ cleaning by lab staff, and the worst part is that folk seem to think that this is purely the role of MLA staff and not the qualified ones too. Do BMS staff feel that these basic lab functions are not their responsibility, or are they above performing these tasks? We need to put some pride back into our labs and our roles. Our labs should be spotless at all times, it's not acceptable to expect someone else to do this. Wait until the regulators (MHRA/CQC) begin to look properly at the general hygiene in departments- should be interesting.
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Example: Lab performs in a year: (not counting Kleihauers/ or product issues 35.000 G&S/year Issues: 10,0000 red cells 1000 plateteles 1000 plasma products. Basic day-to day functions -if fully automated requires; 1 x BMS for blood issues 1x BMS for running G&S bench 1x float person 1x MLA for blood returns/ traceability None of the above includes on the job training/ trainee roles and each post is a wte during core service hours ; 09;00hrs to 17;00hrs Running Q.S and management duties: 1 x quality person 1x blood bank manager 1 x Senior staff IT support Any training required would need additional staff. How would this be extrapolated for the shift hours?
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Hi Robert, There are various papers- but it is very difficult to compare as the automation being used is different (older analysers such as the first generation Galileos (ABS?). The techniques for column agglutination also vary between countries ;in the U.S CAT using Ortho Provue cards are similar to the UK Diamed, not the UK Ortho cards. There was a comparative study performed, that you may already be aware of; MHRA evaluation; six automated blood grouping analysers. There is very interesting/ unexplained data in this report, however, technology has moved on since this was published and it would be very useful and quite important that a further, more up-to-date evaluation was performed, looking more in-depth at the serology as well as the automation.
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Yes, I see what you mean,but ideally ( yes I know i'm living in cloud cuckoo land !) if departments were managed properly , an annual review of all functions/ Q.S functions would show lack of capacity to take on any new requirements, and this would need to be resolved before implementing. As I recall the UK minimum requirements for transfusion laboratories document, released last year, mentions performing an annual assessment of staffing to meet requirements? In addition, you could also build capacity into your lab by 'leaning' systems currently in place.
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That's the whole point of staff/capacity planning; most of us currently struggle to even meet basic training requirements, but unless we formalize this in a document to show senior management that there is a lack of capacity and the consequences associated with this e.g increased errors, cost, regulatory inspections etc, nothing will ever be done about it.
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Thanks for the laugh! But looking at this in a (more positive ?) different way: "Quality is a Journey not a destination."
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How many staff do you need to currently run all aspects of your service ( including the quality issues such as audits, validation, regulatory reporting etc), without falling behind with tasks? If your lab copes with the daily service demands, and there is some slack built in to increase the workload, then this is generally the correct staffing number for your department. You also need to include the time needed for training your staff.
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Hi Jo, the following was cited: Documentation was inadequate in that: Equipment calibration and servicing spreadsheets were not appropriately controlled (Ref: SI 2005/50 9(1)a,b,c,d,e EUGMP 1.2 (iii);vi;2.9;4.2;4.3;5.21;5.23;annex 15#22;#43). But thinking about this further- I do print the equipment spreadsheets off and attach on our lab wall for staff, so the citation is correct, these should have all had a reference /cross- ref'd to an sop. Have you managed to adapt the QI worksheet into an Access database? That's my next step- as I gather Access is far more flexible. thanks for your help.
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Hi Jo, how do you document control these spreadsheets/ workbooks? As this was one given as a non-conf. at inspection, I have since then added a spreadsheet reference, and version number to control the actual template for each worksheet. These details are then held (in another spreadsheet!!!), and will have a formal review date.However, as these are still developing they will most likely be reviewed much more often. My staff are concerned with being able to trace back the previous versions of the spreadsheet, so how do you hold these? How relevant is it to hold the previous formatted template anyway? Thanks
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I currently use various excel spreadsheets in workbook formats: examples are QI workbook contains: QI logs/ status for current year and previous year Audit template of scheduled and ad-hoc audits/ planning for next year spreadsheet of SABRE/ SHOT reports cross- ref to the QI numbers Quality metrics Equipment workbook contains: Equipment log Temperature mapping schedule Calibration schedule PPM schedule Cleaning schedule template I also have excel workbooks for training, management stuff, specific quality stuff. I am sure many of you also use spreadsheets- but how do you manage these with your senior team? How many people do you allow access to modify if these are on a shared drive? Thanks.
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Thanks Tony, but I don't know how you decide a reaction was serious enough to report immediately if you don't have some of the serology results (specifically ones involving red cells). Also how realistic is it to expect staff to initiate a SABRE report - when they are trying to deal with sorting out the reaction investigations? Another thing to consider is that the last SHOT report states that folk are still under reporting reactions. If we go by the suggested guidelines that classify a transfusion reaction- does this mean that SHOT want to be notified of all these reactions - but MHRA only want what we decide is serious? Becoming even more confused than usual!!!!!!!!!
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It's being a little harsh on yourself Malcolm , I think most of what you write is quite good.
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I know some lab staff in the UK are being asked by our regulators to produce a capacity plan for various aspects / maintain compliance when temporary resources are withdrawn. I think capacity planning is also required when there are changes made to shift systems etc. Has anyone actually produced this in a simplified format? I was thinking this could be similar to a gap analysis, looking at what there is currently in place and what we need to accomplish, and somehow address the 'gap'. On the IBMS forum I had posted a similar question, with some very good responses from colleagues- it would be really appreciated if these folk could post their comments on BBT too. thanks!
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Welcome to BBT Craig, I would also be very interested to learn about veterinary blood banking. good to have you join us!
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Hello Palin, Welcome to BBT.
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Hi Pluto, the information I have received is that the first draft is nearly complete, but the process will take several more months so unable to set a final date.
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Hi Marc, it's also important to know the lowest temperature of the freezer , as blood bags become brittle and fracture easily at very low temps. This is obvious when folks start seeing a higher than average breakage of their FFP on thawing.
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I think there has been a complete misunderstanding in what L106 said, she was merely thanking Malcolm (as I had) for a very clear explanation being given. Many of us on this site are also lab managers -with many years experience, but we are not adverse to being taught something new or even given a clearer explanation of things we may have already known. This site is purely about learning and communicating this to others regardless of how experienced we consider ourselves to be. This requires a far humbler approach, and that is the impression I got from those comments.
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In the UK we are expected to have all thermometers recording fridge temperatures or used for fridge mapping purposes to have been calibrated against a national standard thermometer, and be within 0.5'C of that calibrated instrument. This would then give a tolerance of 1'C between the instruments (+/- 0.5'C) ; the importance of this is that your fridge could be recording 6'C ...but this figure may in reality be anything between 5'C and 7'C. If the tolerance was 2'C the "real" range of the storage temperature would be even greater (4'C- 8'C) etc.
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Oh but aakupaku......it's so much more fun having to deal with patients with weird and wonderful antibodies. At my previous hospital we had quite a few with anti-U, anti-Jsb etc... and about half the total number of patients in the UK with post-transfusion hyper-haemolysis on top of this (though I may be wrong about this- I think there were approx 4). Life was never dull.
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Thanks Tim, I should have explained that in a better way. As you have said it is crucial that you pre-define your acceptance criteria ( and possibly rejection criteria?) before the testing begins, this also helps you to focus the testing and not deviate from the plan (unless you really need to- but this would also be documented).
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Hi sona, Can we assume that each patient you tested the unit against had a negative antibody screen by IAT ? Also, are the screening cells produced in the same country where you are based and therefore similar to your patient population?