blood bank services for off site center

[bbville]

A new physician-owned surgery center wants our hospital to provide transfusion testing and blood supply. They are located about 5 miles away and do not want their patients to come to our hospital as in or outpatients if they need blood. They provide no laboratory services there other that some POC I-Stat testing. Somehow they have gotten Red Cross to provide them with 4 units of O neg blood to keep on site. There are so many things that need to be in place for me to agree to this. They have no written policies or procedures as far as I can tell. Does anyone have experience with a situation like this? No one there even knows what I mean when I mention atypical antibodies and I do not trust the person who manages the center.

[Mary**]

:disbeliefI am guessing that you are located in Southern Indiana. That surgery center is asking everyone to provide blood for their surgery patients. I declined due to the regulatory issues and the complications that would have to be dealt with. I believe there is such a service in the Northeast U.S. (?Puget Sound)!

[jhaig]

This may sound like rambling, but I'm in rare form today, so here goes...:mad:

Boy, this sounds like a whole bunch of trouble which you don't want any part of. Set aside the regulatory issues, procedures, inspections, etc. They don't want their patients coming to your facility, but they want you to provide transfusion services? What about patient care? I don't know what kinds of surgeries they will be performing, but what's going to happen if one of their surgery patients goes into DIC and they need plasma, cryo, and platelets? They'll want your help then, I'll bet.

Unless they can come up with a blood banker on staff to handle the multiple regulatory issues, inspections, and so on, I wouldn't make any committments. I wouldn't feel comfortable with any type of satellite set-up unless the other facility has a dedicated blood banker that can be relied upon to handle pesky matters like antibody identification (which you say they have no idea about) and everything else involved. I'm actually amazed that the Red Cross has allowed them to store blood on site without any evidence of written policies or procedures.

[bbville]

Mary - you are correct as to location. They are now saying they will send all the pathology specimens to our docs if we work with them on this (but I wonder if they really will). I did visit the facility today and it is quite impressive. It drives me crazy that they are willing to provide top of the line equipment, but will not spend the money that they should to provide safe blood products if needed. They are offering nothing for what would be professional consult services. We would have to start from page one on writing policies and procedures. I can't imagine how they were inspected by the State Board of Health and the Joint Comission and the topic of blood never came up.

[Likewine99]

The rules and regs are there for a reason, patient safety being number one. I too am surprised at the ARC for letting them store blood there.

[David Saikin]

Do I understand - just uncrossmatched O=s for their patients? What is it that they want you to do? I would stay away from this one. Watch out for the end around play/they'll hit up your administration to force the issue. You could always counter offer with what you would require in order to become involved . . . but. Years ago at a place I worked there was a stand alone, private surgery center in town. Occasionally they would run into a bleeding problem - the patient had to be transferred to our hospital. What are the ramifications if they run into the same problems - will you transfer them blood? DON'T DO IT, as it stands now.

[Mary**]

Those are some of the reason I declined. You would be held responsible. I also don't think untrained people "signing out blood" is a good idea either. If they are mainly going to do total joint replacments, I don't think the Pathology specimens will be big ticket items.

[tbostock]

Check your state regs; an off site surgical center here in NY State also wanted to do this, but the State regs concerning limited transfusion services scared them off.

[bbbirder]

We have a stand alone surgery center in our town. They are about 5 miles away from our hospital. They are required by the state (MO) to have provisions for handling bleeding, despite the fact that they do no procedures that would normally be associated with bleeding.

We have an agreement (contract) with them to provide blood in an emergency. (O negs picked up by them; and then the patient will be transported to us.)

We review the contract periodically. In 7(??) years they have never needed to use us for anything.

Since they compete with us for business, this needed to be approved by the upper administration of our hospital.

I don't have any problems with this arrangement, but it sounds like what this center is requesting is way over the top.

Linda Frederick

[AMcCord]

To quote a fine movie I once watched..."Run, Forest, Run!".

We got hit with the same issue and "you order and store tendons for us and eat the cost if we don't use it and nothing in it for you" and "store our corneas for us and deliver them to us for no compensation" and more, much more. Our administration won't play. Direct competitors... What is wrong with these people!!!

The physician who put together the center 2 miles from us (we're talking a rural area here) has privileges at our facility. When he announced the plans - big news conference - he called it a win-win situation for the center and us at the hospital

Phew! I feel better now.