goodchild

For all institutions which have instituted greater than 7 days pre-admission testing, how do you have it set up for the pre-in account and the day of surgery account so that the results and whatnot are both there? Our registration department insists that billing/account compliance prevents them from registering pre-in accounts >7 days out from the day of surgery.

Concur.

They're still applying an incorrect interpretation of CLIA as it pertains to Transfusion Services (immunohematology). All blood bank activities are high complexity. High complexity testing doesn't have a 'technical consultant' designation. They have technical supervisors and (without re-reading) only MD, DO, and maybe doctor of podiatry(?) qualify. Technologists who Lead/Supervise/Manage/Senior Tech (however your organization calls it doesn't change the CLIA interpretation of personnel) have to be qualified as general supervisors. General supervisors may perform competency assessments. If you qualify as testing personnel and have two years of experience in high complexity testing (which it sounds like you do), you are qualified to be a general supervisor.

Welcome back @Brenda Hutson, haven't "seen" you in a while.

They always want you to think it's almost ready.

Did someone hack Scott's account?

We do 7 days presurgical patients. In-patients: 3 days, day of collection is day 0 (i.e. 96 hours).

@idsirnate1 Your institution needs to have another look at CLIA/CAP requirements. Here's a link to the CLIA competency brochure that explains it in an approachable format: https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Downloads/Survey-and-Cert-Letter-13-07.pdf To perform competency, you need to be a technical supervisor, which for immunohematology requires a doctor. The technical supervisor can delegate competency to a general supervisor. In high complexity testing environments (all blood bank is high complexity) to be a general supervisor you only need an associates degree and two years experience of high complexity testing. Truth be told you don't even need an associates but can meet qualification with a long list of other comparable training/education. CAP follows CLIA guidelines for general supervisor qualifications (it doesn't spell them all out, but it couldn't because there are a dozen pages of grandfather clauses or alternate pathways) and competency assessment performance. Feel free to message me and I'll ramble on at greater length, if it will help you.

I like how your document control system gives generated documents a single day expiration date. I wish ours would do something similar.

I'm so confused by this discourse.

Thank you for keeping us updated.

I believe that practice stopped before you were born.

I've meant to ask, how do you handle complement?

This is the perspective our institution follows.

Do most institutions require a change of gloves with every issuance of blood? That's not part of our procedure.

I'm curious about your planned use of middleware. The rest of our laboratory uses middleware (and specifically DataInnovations).

Doesn't ring a bell.

When we run into scenarios like this we will routinely test against the more common low incidence antigens (e.g. Jsa, Kpa, Cw). I think it makes all of the techs feel better.

Concur.

That's certainly terrifying. Thank you for sharing.

Isn't O Neg, c-neg blood ludicrously rare?

Leaving a note here to remind myself to come back to this tomorrow.

https://www.cms.gov/Regulations-and-Guidance/Legislation/CFCsAndCoPs/Downloads/CMS-3244-F.pdf

Thank you for slightly improving a miserable Monday morning. Bahahahahahahahaha.

This is something the vendors certainly glossed over while doing their demo. I'm not certain I fully understand.