Mutiple site locations questions

[BBKT]

We are two hospitals with two blood banks and two different CAP numbers. Both hospitals are owned by same facility, and have the same computer system, same medical director and same supervisors. Can we transfer blood between the facilities without re-confirming unit blood type and/or unit antigen type if an antigen negative unit is at one blood bank and the other blood bank needs it?

[PAWHITTECAR]

I would say no. Because they have different CAP numbers ans are in different locations I would think that you would have to trat it as a transfer between hospitals and re-confirm.

[R1R2]

I am not sure if CAP has anything to do with it. I would say no.

[Dansket]

We are two hospitals with two blood banks and two different CAP numbers. Both hospitals are owned by same facility, and have the same computer system, same medical director and same supervisors. Can we transfer blood between the facilities without re-confirming unit blood type and/or unit antigen type if an antigen negative unit is at one blood bank and the other blood bank needs it?

Are your patients and donor units intermingled into the same database or separate databases for each facility? If unit of blood is physically delivered to facility A and logged into that computer system, does that unit also display as available in the computer inventory of facility B? Can facility A see the unit confirmation test results entered into the computer by facility B?

If your donor units are not in a database shared by both facilities, then I would re-confim the unit serologically. It may be simpler than making a bunch of computer transactions as a work-around.

[Eagle Eye]

You definetly need an agreement specifying all the details. AABB inspector may ask you for the agreement between two facilities.

[tbostock]

I don't think there is a reg on this. We used to be in an identical situation with 2 hospitals. I was the supervisor for both places, and we had identical procedures, reagents, etc. So we did not require performing the testing again, the computer system kept track that this was already done at the other site. Never had a problem with inspectors on this one.

[pinktoptube]

To add to this, are there any hindrances for hospital A to perform the type and screens (and possibly computer crossmatch using hospital B's units) and hospital B (possibly tags) dispense/transfuse the units?

I don't believe hospital B can perform any crossmatch without a physical sample on hand.

[Malcolm Needs ☆]

7 hours ago, pinktoptube said:

To add to this, are there any hindrances for hospital A to perform the type and screens (and possibly computer crossmatch using hospital B's units) and hospital B (possibly tags) dispense/transfuse the units?

I don't believe hospital B can perform any crossmatch without a physical sample on hand.

Remote electronic issue of blood has been around for years now.

[ChrisW]

We have multiple hospitals in our system. One hospital does antibody work for all the others, including providing crossmatched blood ready to transfuse. We do not re-confirm blood type on units when we transfer; receiving hospital does not re-crossmatch the units. This is clearly spelled out in the procedures shared by all the facilities. Each facility has different CAP # and only the largest one is also AABB. 

[Teristella]

We do not reconfirm units sent to or from our sister hospital because they do not leave the LIS inventory.

 

Different licenses, same supervisor, same hospital system.

[goodchild]

Out of curiosity, how are laboratory investigations of transfusion reactions handled when the patient's pretransfusion sample is at a different location?

[pinktoptube]

16 hours ago, Malcolm Needs said:

Remote electronic issue of blood has been around for years now.

Thanks Malcolm.

[Malcolm Needs ☆]

I think my comment may have been a bit more helpful if I had actually quoted a reference!

One such is, Cox C, Enno A, Deveridge S, Seldon M, Richards R, Martens V, Woodford P.  Remote electronic blood release system.  Transfusion 1997; 37: 960-964.

As you can see, this paper was published almost 20 years ago now, and one would suspect that improvements in computers and information technology, particularly with reference to safe release of blood, or rather preventing the unsafe release of blood, would also have improved over this time.

[Teristella]

22 hours ago, goodchild said:

Out of curiosity, how are laboratory investigations of transfusion reactions handled when the patient's pretransfusion sample is at a different location?

If the patient was drawn at one hospital and transfused at the other facility, we just transfer the specimen and change the performance site of the workup as necessary. If they were transfused at our sister hospital this would probably have to occur even if the patient was not transferred, as we don't currently staff a blood banker over there past 3 p.m. In that case, we'd transfer everything, pre and post samples, urine, any bags and tags returned, etc. so the workup could be performed over here.

[SMILLER]

Simular here to ChrisW, above.

 

Scott

[tricore]

We have two hospital systems and one commercial lab on the same computer system. The blood products are essentially in the same "pot" separated by location.  For one of the systems, the main hospital receives the RBCs from the supplier, performs the ABO/Rh retype, then ships the RBCs to the smaller hospitals transferring the products from one inventory to the other. Same for Antigen typings.

The hospital and UBS presented a poster about this at AABB a few years ago.