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Does anyone who has a Tissue Bank in the OR do the Quality Coordination for them?  Or do some of you have Quality Coordinators who reside in the OR department rather than the lab?

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Last year we had to completely take over tissues; all tissues and equipment was brought to the Blood Bank.  You can imagine why without me having to air dirty laundry. :)  We order them, track them in our computer system, issue them, etc.   It about tripled our work load.  We went from 4 different blood components from one supplier to dozens of bones/tissues with about a dozen vendors.  Can you tell how much I love it?

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We changed our structure within the last couple of years. The Blood Bank Medical Director is also the Tissues Director. From him/her the tree branches to the Directors of Surg and Lab. There is a day-to-day coordinator, paperwork chaser, policy writer in each department. I have the 'pleasure' of being in that position for lab and there is an RN in surgery that handles things on their side. (The two of us get along famously, which makes life so much easier and we have the full support of our respective Department directors.) Blood Bank is responsible for anything frozen or refrigerated - ordering, issuing, tracking, billing etc. Surgery handles everything else.

Where we meet/overlap, we have one set of SOPs that cover both lab and surgery. The RN and I worked through our respective policies for those areas and wrote new ones that fit both area requirements. We covered lookback, quality issues, ordering and issuing for use, vendor qualification, stocking, etc. Pretty much everything is done following the standards we've been using in Blood Bank for blood products. These policies are now found in the hospital policy manual under the surgical section and I've loaded them into document control for Blood Bank/Tissue policies - same policies both places. Then we each developed additional policies for our own areas to fill in anything that wasn't covered in the joint policies. When we were inspected by Joint Commission last fall they were very impressed by our policies and our cooperation - winner! And yes, it is a lot of work, but we feel it is the best way for us to ensure good care for our patients.

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When you say you are responsible for the frozen or refrigerated, are those tissues physically in the Blood Bank or in the OR?  Do you do this as a full time position, or in addition to other Blood Bank duties?  Thank you for the feedback!

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15 hours ago, caandrew23 said:

When you say you are responsible for the frozen or refrigerated, are those tissues physically in the Blood Bank or in the OR?  Do you do this as a full time position, or in addition to other Blood Bank duties?  Thank you for the feedback!

These tissues are physically in Blood Bank. I'm the Blood Bank lead, so I'm wearing many hats - including tissue management. We are a 150 bed rural hospital that is one of the top ten size wise in this state, so we do some interesting things. Surgery has physical possession of the greater % of stuff - freeze died tissues, implants, etc.

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OR tisssues regulated under the hosptial CLIA license, not regulated by blood bank license. When asked to have BB take over, my CAP consultant said "say no and run". I just showed them (OR) the difference in regulations and they kept the tissues.

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Recently OR tried to get me to take over everything on the grounds that they were 'too busy' and were struggling with the necessary documentation for regulatory compliance. (They are currently looking for some magical software that will do a big part of everything for them, including vendor qualifications. If they find it, I want in on it, too. :work:) I told them they were doing just fine, offered to advise them whenever they needed help with regs and I explained to them that Blood Bank was equally 'too busy' and doing the same type of documentation for ALL of our blood products, as well as the frozen/refrigerated tissues. That, plus the fact I don't have the physical space to store all that other 'stuff'.

The whole process of setting up tissue/implant tracking and policies for surgery has been an eye-opener for surgery and some of nursing management. I think they are beginning to understand a little why Blood Bank has to operate the way that we do and that when we make rules, it isn't just to make more work for nurses. The process of combining forces for tissue management has also gifted me with some great contacts in Surg Services, who I've reached out to for other projects.

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At our place the Medical Director of the Lab/Blood Bank is also the Medical Director of tissues.  And in NY State, they except lab oversight.  It very difficult to have oversight of something that is completely out of your area and out of your control.  It's not a fun process; I would also suggest to "say no and run" but if your hospital is cited, you can run but you might not be able to hide for too long.

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AMcCord, where do I sign up for the paperwork chaser job?  :P  I am highly qualified, I've been around since paper blood banking days and have chased many an "uncrossmatched release form" and many missing transfusion slip.

I don't envy any of you having to manage tissue and bone.  Good luck to all.

 

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On 1/21/2016 at 7:54 PM, Likewine99 said:

AMcCord, where do I sign up for the paperwork chaser job?  :P  I am highly qualified, I've been around since paper blood banking days and have chased many an "uncrossmatched release form" and many missing transfusion slip.

Put in your application! I'm sure we can work something out...:haha:

 

 

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