bmarotto

Welcome QA Bob. I have seen you post on the AABB boards. You certainly keep busy. I feel the need to take a nap after reading your bio.

With all due respect labgirl, you asked for opinions. It appears you only want to hear opinions that are in line with your way of thinking. Differing opinions are healthy. Sometimes we come to see things differently and sometimes we have to agree to disagree. It is a shame this thread will probably end now that you have decided to take the discussion elswhere. :disbelief

I believe this is the item you may be looking for: http://www.wescottlabs.com/bldbnk/labaccessories/la-ttv.php
I do not believe in routine microscopic readings but I do find it helpful to detect weak mixed field reactions.

We have had SCC Softbank as our Blood Bank system since 2008.  Our lab was on Sunquest lab until March 2015 when our facility implemented Epic and the Lab went on Epic's Beaker.  I was very heavily involved with the Epic/Beaker/Soft implementation.  We brought up new inbound (ADT/Orders) and outbound (Results and Billing) interfaces.  We were also one of the first sites to go live with Epic's BPAM (Blood Product Administration Module).  Soft was able to send the required result components necessary for BPAM to work.  The only thing missing is the product expiration, which has to be scanned at the time of transfusion.
We have always been very happy with Softbank and the features it offers. It is very user friendly.  I have staff who have formerly worked with Sunquest, HCLL, and Meditech and they have all said that Softbank is by far the easiest to learn.  Implementation support has been great.  I found that Epic was not very flexible in their interfacing and expected Soft to make changes to accommodate Epic workflow.  Soft always managed to come up with a solution that worked for us.  Blood Bank tests are processed through Beaker.  We were able to have the Beaker labels for Blood Bank specimens configured so that the specimen ID number can be used on our Blood Bank instruments.  Soft files this number as an "Auxiliary Order Number" so there is no need for relabeling.  The billing has been flawless from the start.  We do have SoftLab which sort of runs in the background and there is setup that has to be done in SoftLab as well as SoftBank.  Most of the reporting as well as billing are done by Softlab and it is Softlab that interfaces directly with Epic.  We have found ongoing technical support to be very good.
In August 2015, we brought two affiliate hospitals (formerly Meditech sites) up on Epic/Beaker/Soft.  Soft was very supportive in assisting us with the multisite build since this was our first experience with a multisite environment.  The next hospital should be easier!
I would not hesitate to recommend Soft.  No matter what Blood Bank system you select I strongly suggest you have a Blood Bank person involved in the Beaker build, or at least present during discussions.  I did not have Beaker training but I have been told that during the training out at Epic there was little to no mention of Blood Bank.  If you have non Blood Bankers building Beaker, they may make decisions that will cause you problems down the road...like being able to add lab tests on to a Blood Bank sample.  Another suggestion is to be sure to be involved in the build decisions and test blood product orders with every Beaker module.  My experience was each group tended to do their build in a vacuum, despite trying to get them to attend unified blood workgroup meetings.                    

We use Igloo Playmate MaxCold.  We validated them with five "dummy" units of red cells, one had a probe from our centralized temp monitoring system inserted into the bag.  At 24 hours, the temperature was reading 6.3C.  At a more realistic 10 hours, the tempeature was in the 4.5C-5C range.  We also have three of the large chest size for massive transfusions and liver transplants.  They validate even better!  These coolers are well made and MUCH cheaper than the Thermo ones.  Make sure you get the MaxCold series.  They are blue and white. 
 
Of course, the best cooler on the world is not going to work if they keep the lid open.  That is why we use an infrared gun thermometer to record the temp of all returned units. 

We do not QC panels.  Like John, I do not see the value of arbitrarily picking an antigen to QC.  "Smoke and Mirrors" is not a game I like to play.  I will hold out until told otherwise (hopefully I will be retired before then).

We do not QC panels.  Like John, I do not see the value of arbitrarily picking an antigen to QC.  "Smoke and Mirrors" is not a game I like to play.  I will hold out until told otherwise (hopefully I will be retired before then).

I have never qc'd panels and will be ending my career with that same statement, mostly, because at my current and final employer we don't perform antibody id's.  This discussion is not a new one and will continue to pop up with new inspectors and new interpretations of old rules.  Frankly, there is not anyway to realistically QC a panel and have confidence that the every antigen listed is detectable.  Frankly I am surprised at the number of folks responding that they do some form of panel QC.  In my ever so humble opinion you are providing nothing but smoke and mirrors to pacify some inspector.     I suppose that as long as you are successful at this it's worth the effort.

You will love Softbank, David!  We have had it for Blood Bank since 2008.  We are going live with Epic and Beaker Lab the end of this month.

Guidance from our State Dept of Health has been (so far): no Blood Bank tests, and everyone gets O Neg uncrossed. 

Yes, we have SoftBank and we got rid of our bands because of the reason you mention and many others.  It became more trouble than it was worth.  When we got SoftBank, we went to electronic crossmatching, which requires two separately drawn blood types before non-type O blood can be issued.  We also implemented barcode scanning at bedside for patient ID when drawing samples.  So we felt that those two additional safety measures were enough reason to feel comfortable about removing the bands.  Our error rates are lower than ever and we'll never look back.

I would suggest your best option would be to contact other blood suppliers and see what they are willing to do for you.  Most of us do not have the option of shopping around. 
 
I would love to get into a discussion about CFOs but I'm afraid Cliff would burn my membership so I think I'll refrain.

Just tell them to keep those units moving at all times until they hang them.  We issue our units in insulated lunch bags with small cold packs.  Grab that bag by the handle and constantly swing it back and forth.  Yup, that is just as ridiculous as the dual temperature requiement.  Can anyone honestly say when they are receiving blood that the temperature does not exceed 6C?  Unless you are in a cold room when you unpack, pull segments, and log the units in....  

I also went through this with Soft.  Each blood type of Octaplas has a different product code.  Group AB is X0004000 for the frozen product and X0008000 for the thawed product.  The product is not labeled with an Rh  Soft says they are waiting for ICCBBA to provide them with specs for the Octaplas labels.  I was able to print the thawed product labels manually using Shift-F9 but there is only the barcode and eye readable number.  The product name does not print. I was not able to scan in the DIN because it begins with the country code X.  Soft currently only recognizes W for USA and C for Canada.  You can manually type the DIN in and it does not ask for a check digit..

We use the same criteria (Hgb <7.0 gm) but are more lenient with outpatients who are transfusion dependent.  For example, a patient who receives blood on average every theee weeks comes in and the hemoglobin is 7.4 gm.  We know he/she is not going to make it three weeks and will end up coming in emergently needing a transfusion so we allow them to transfuse.  The studies were done on hospital inpatients, who are having labs monitored daily and many are expected to have their Hgb recover without transfusion.  We know the transfusion dependent outpatient or chemo patient is only going to continue to have a fall in Hgb.  Just my two cents. 

I agree with Terri.  SoftLab pretty much runs inthe background as far as the BB techs are concerned.  SoftBank is a great system.  I highly recommend it.

Using expired antisera and panel cells is and has been standard practice for years in my experience. It has become more sound with additional QC people are now doing. If ever cited for this I would push back. Provide scientific rationale and a risk evaluation for what you are doing. These are tools used to solve problems. Without them your hands are tied and patients may not receive compatible blood. A bigger risk.
 
No matter what you call them (inspectors, investigators, assessors) they all have opinions and you may not be about to change their mind during the inspection. What they may cite you for during an inspection can be disputed in your response. The repsonse is typically reviewed by others.
 
Some of these things are just driving up the cost of health care without improving actual patient care.

I want an app like this for studying for the SBB.  C'mon, someone get on that! 

We had a patient many years ago who had repeated intravascular hemolysis during or after most transfusions.  No antibody was detected by us or our Red Cross reference lab.  I phenotyped the patient and each transfused unit and suspected anti-C.  Samples were sent to George Garratty's lab and they detected anti-C reactive using manual polybrene testing.  

I have two technologists who went through online SBB programs.  They both passed the SBB exam on their first try. 
 
One went through UTMB.  http://shp.utmb.edu/sbb/
 
The other went through Indiana Blood Center  http://www.indianablood.org/hospital-services/education/pages/sbb.aspx

Seems a bit of a waste of time doing a retrospective in vitro cross-match when a real time in vivo cross-match has already taken place!

Soooooo... If everyone in the department make the highest evaluation level will they all get the highest possible raise?  The reason I ask this is when I was supervising at my previous life we were told that we could give anywhere from a 0% pay increase to a 6% pay increase based on the evaluations, BUT the department must average 3% pay increase.  So if I gave a 6% I needed to balance that with a 0%.  I don't know about most of your blood banks /transfusion services but mine not only did not have any poor performers, I had damn few average performers with most rated at the top, so guess what happened.....     

I have two technologists who went through online SBB programs.  They both passed the SBB exam on their first try. 
 
One went through UTMB.  http://shp.utmb.edu/sbb/
 
The other went through Indiana Blood Center  http://www.indianablood.org/hospital-services/education/pages/sbb.aspx

Sorry I am late.  I hope everyone had a wonderful Christmas.  
 
HAPPY NEW YEAR   

Sorry I am late.  I hope everyone had a wonderful Christmas.  
 
HAPPY NEW YEAR