There's been a debate over dropping CAP accreditation after the VA did it.  Has anyone done this?  Please share any pros/cons you experienced.  Right now we can only speculate.   That would leave us with Joint Commission, CLIA/FDA, and AABB.

We dropped AABB for our satellites - these days I'm even questioning the need for the largest Blood Bank to stay with AABB.  Combing through multiple standards and performing 2 self-inspections with minimal staff and trying to keep things running makes me wonder why we need both CAP and AABB- especially with the fees that are charged. AABB wouldn't answer either phone or email about getting a copy of the new standards so we had to purchase them.  

We have been used HFAP (now part of ACHC--Accreditation Commission for Health Care) for at least the past 20 years.  I have no experience with any other accreditation organization so can't really compare to CAP, but they are another option.

My current hospital lab is JC and FDA inspected. My prior lab was CAP, with the hospital being JC. I honestly don't see a difference without the CAP inspection here, as we follow all AABB standards anyway. We used to be AABB inspected in BB, but dropped it in 2004 or 2005, before I got here, due to costs and not much gain for a hospital transfusion service that doesn't irradiate, wash or pool. My two cents: you don't need inspections by 4 organizations, just pick one.

In New York State, we also are inspected by the state.  FDA, NY State, AABB, CAP.  You can make a sound argument that this is wasteful and duplicative.   Obviously we don't have any choice about FDA and NY State.  CAP and AABB, as accreditation organizations, will accept the results of each other's inspections, which is a plus, but you are still dealing with two sets of requirements.  My advice to smaller facilities is to pick one if you can do so, and not duplicate your efforts and expense.  Both organizations are essentially trade organizations, not scholarly/research societies. They both provide important educational opportunities, but you don't need both to keep your staff current, in my view.  With the shortage of medical technologists, reducing non-productive non-clinical effort is a priority to prevent staff burnout and keep everyone focused on the main mission, patient care.

A number of years ago in a meeting of the corporate transfusion service supervisors we discussed the possibility of dropping our AABB membership.  After much discussion the corporate transfusion service medical director decided that we would not be dropping the AABB membership.  Her reasoning, the prestige of being in charge of a group of facilities fully accredited by AABB was very important to her.  She actually told us that!

I'd be in favor of keeping both CAP and AABB.

If one of them is doing your CMS inspection, then the other can be used as "practice".

17 hours ago, Cliff said:

I'd be in favor of keeping both CAP and AABB.

If one of them is doing your CMS inspection, then the other can be used as "practice".

Personally, I never minded inspections/assessments.  My blood bank and transfusion service were "visited" no less than twice every year by inspectors.  Either FDA (we were licensed to ship blood interstate at one facility I supervised), AABB, CAP or JCHO.  Being inspected that often meant we never had the opportunity to let things slip unlike other areas of the lab that were inspected less frequently.  On the other hand it did become very expensive paying memberships as well as buying materials required to stay current on the requirements of each agency.  When cost cutting measures were called for reducing in this area was always discussed but for some reason was never acted upon.

 

3 minutes ago, John C. Staley said:

Personally, I never minded inspections/assessments.  My blood bank and transfusion service were "visited" no less than twice every year by inspectors.  Either FDA (we were licensed to ship blood interstate at one facility I supervised), AABB, CAP or JCHO.  Being inspected that often meant we never had the opportunity to let things slip unlike other areas of the lab that were inspected less frequently.  On the other hand it did become very expensive paying memberships as well as buying materials required to stay current on the requirements of each agency.  When cost cutting measures were called for reducing in this area was always discussed but for some reason was never acted upon.

 

I agree, except for the first time Red Cell Immunohaematology at NHSBT-Tooting Centre were inspected by the Medicines and Healthcare products Regulatory Authority (MHRA), who had previously only inspected the donor side of things.  We (RCI) were "inspected" by the top inspector (no name, no pack drill), who knew s*d all about blood group serology, but who was determined to make his mark by finding anything he could (however minor) and making it a major.  As a result, we lost six months of screening for rare donors (it's a long story).

Since then, I agree with you that more inspections actually help (and the MHRA inspectors now seem to have done their homework - although most of them would still not pass a reasonably difficult examination in blood group serology - but at least they now realise that).

Malcolm, my very 1st AABB inspection came about 2 months after taking the Blood Bank supervisor job.  After it was over I contacted AABB and told them that I would never let that inspector in my facility again and if they tried to send her I would drop our AABB membership.  YES, the inspection/inspector was really that bad and luckily I never had to carry through with my threats/promises.  

We are currently TJC, AABB and FDA inspected.  They each take a different tack.  AABB requires more auditing and data gathering which we sometimes have difficulty doing with current resources. This site has not been CAP in the 14 years I have been here.  My previous lab switched to TJC from CAP just after I left there.

I have always done joint CAP/AABB inspections and the CAP portion is almost negligible. I don't see a huge pro to dropping CAP if you are already AABB, since the two are very rarely in disagreement, and AABB tends to have stricter guidelines.  

On 8/26/2022 at 11:26 AM, John C. Staley said:

Malcolm, my very 1st AABB inspection came about 2 months after taking the Blood Bank supervisor job.  After it was over I contacted AABB and told them that I would never let that inspector in my facility again and if they tried to send her I would drop our AABB membership.  YES, the inspection/inspector was really that bad and luckily I never had to carry through with my threats/promises.  

I had one of those inspectors.  

Thanks everyone for the feedback!  ACHC looks like a great alternative to CAP for many reasons.  Might investigate that route.