So much of the differences in the US comes from the complexity of the governing bodies (FDA, AABB, state and local governemnts - crossing statelines.....etc.) and the relationships between the hospitals and the blood distribution agencies (also numerous (local, state, national....). Not to imply anything, but size and the distances involved do have a lot to do with it too (think Montana, Wyoming...etc). Many of our smaller, rural hospitals are a long way from a reference lab - everything is flown or shipped FEDEX, etc. My local blood distributor sends reference lab work to another state - can take 2 days to get answers back - ugh! I ship my stuff even farthur, but the reference lab I use (Gulf Coast Regional Blood Center, Houston TX) can get it out in 15-24 hours after receipt (many kudos and thanks to them!!!). Many of the for-profit hospitals have contracts with the huge, national reference labs - Quest, LabCorp, etc - again shipping and waiting for answers. Since some of these labs don't even have blood - of course, they don't crossmatch for the hospital. There are a few regionalized blood centers who solve problems, crossmatch and ship blood back to the hospitals (Puget Sound in Washington state comes to mind). There are many methods for the many regions and states and systems - one kind of answer just won't cover the States.

c) NO. I mean there were no atypical alloantibodies present (by a multitude of techniques, except super glue), and the money spent on us doing this is wasted!!!!!!!!!!!!!!!!!!!!!!!

:D:D:D:D

HaHaHa!! Perhaps super glue is the future of Blood Banking!!!:D:D:D

We also quiz and emphasize things that have been more of a problem in the past year. And once in a while there will be a sentence inserted into a new policy that, when found and brought to the supervisor, gets a candy bar. It makes it a little more fun. And of course the typo's are always a good check as to who reads and who doesn't. There are people who love to point out spelling errors.

We also quiz and emphasize things that have been more of a problem in the past year. And once in a while there will be a sentence inserted into a new policy that, when found and brought to the supervisor, gets a candy bar. It makes it a little more fun. And of course the typo's are always a good check as to who reads and who doesn't. There are people who love to point out spelling errors.

I think I'll try this.

Then I can get them for having food in the Laboratory too!!!!!!!!!!!!!!

:devilish::devilish::haha::haha:

Knowing where to eat the candy bar falls under the safety competencies. 2 tests in one.

knowing where to eat the candy bar falls under the safety competencies. 2 tests in one.

splendid!!!!!!!!!!!!!!!!!!!!!!!!!!!

:d:d:d:d

a) You do - but I don't care!

I'm not sure, because this is handled by Doris Lam (my excellent deputy), but I do know they all get time.

c) NO. I mean there were no atypical alloantibodies present (by a multitude of techniques, except super glue), and the money spent on us doing this is wasted!!!!!!!!!!!!!!!!!!!!!!!

:D:D:D:D

Malcolm, Could you fill me in on the Super Glue Technique, I couldn't find it in the Technical Manual. Do you use it INSTEAD of AHG, or is it a potentiator? (sorry, couldn't resist...):sarcastic

Malcolm, Could you fill me in on the Super Glue Technique, I couldn't find it in the Technical Manual. Do you use it INSTEAD of AHG, or is it a potentiator? (sorry, couldn't resist...):sarcastic

I really do wish I could, but it is a technique used, I think, exclusively by some of the hospitals my Reference Laboratory serves (in particular, by those hospitals in the east of the county), and one that we have yet to master ourselves!

I sometimes fell that we are unworthy of performing tests for those in my mind, because we can rarely find these "antibodies" that they, apparently, can regularly detect!

On Saturday, for example [and just in case Rashmi gets even more paranoid, it wasn't her Laboratory] I had a sample in on a patient with a GI bleed. DAT+ 4+ IgG only and a panagglutinin true, but free auto-antibody in the plasma gave results far <1+ [one or two cells making love to each other, whilst the vast majority were being wall-flowers] and I had to hold their hands and cross-match for them, whilst the patient had to wait about 4 hours for their transfusion [given the time it took for the sample to get to me, me to test it, me to cross-match it, and then to get the blood back to the hospital.

I am still really worried that I could not find this auto-antibody, just in case......

The patient is fine, by the way!!!!!!!!!

:D:D:D:D:D

Perhaps we need to introduce those hospitals to the WD40 technique. It is very slick!

Hijacking this back to the main thread for a sec My apologies I got distracted by Xmas and haven't checked back in a while - Merry Xmas all btw!

In response to Bmsjbatt (I think) that asked me what email system and how the voting works - we use Microsoft Office Outlook and the voting tool is in the options menu. You just tick the box next to voting and then put in whatever voting options you want (eg Read, N/A) separated out by a semicolon. To make sure that staff realise that they need to vote I mention in the text of the message that they need to click on the "read" button when they have done just that Oh and I also make up a group email of staff in our laboratory as a personal group list (if you can't do this organisationally) - this also means you can target groups of people ie I had a staff list of the seniors in the lab, or the ones who had worked in the reference lab etc etc

Hope that helps

Denise

I have designed the Transfusion Training Record to include a column with relevant procedures and methods doc references, and a column for staff member to sign and date that they have read them. This is reviewed annually at their performance appraisal. There is now always proof that docs have been read; if I update a procedure, I have list of staff names attached to the procedure, and they all have to sign and date as a record it has been read. Hope this helps. Cheers Lynda

All these new techniques: Super glue, WD40... and I thought the Antifreeze (PEG) technique was the epitome of tube testing in the BB. Boy do I have a lot to learn after only 25 years in the laboratory. Never too old to learn new tricks...not this ol' dog!

I once had a very wise Pathologist boss who used to say "It's not how much money you make, it's what you do with the money that you do make!"

He had many other wise sayings, such as "think carefully about which battles you pick." He truly was a "mentor" type of boss to all his staff. (Maybe in addition to our "Just for Laughs" string, we should also have a "Wise Sayings" string!)

My favorite saying of all-time actually comes from my father (not work-related at all)....."Win the wars, but choose your battles carefully."

Meaning (for those of us already practicing for New Year's Eve) if you constantly try to fight all the little battles you come across, when a REALLY important issue...ie..a war happens your input will have less meaning if you constantly fight everything.

OK L106....where's our "wise sayings" string???

All these new techniques: Super glue, WD40... and I thought the Antifreeze (PEG) technique was the epitome of tube testing in the BB. Boy do I have a lot to learn after only 25 years in the laboratory. Never too old to learn new tricks...not this ol' dog!

LOVE THIS!!! I hadn't ever thought about WD40....:D:D:D

Rashmi, I don't know if this helps or not but our Laboratory implemented a comprehensive document control system as part of our ISO15189 accreditation. We actually purchased a document control software package that we use throughout the Lab (not just in Blood Bank) that requires, documents, and tracks annual staff review of SOPs. It works very well for us.

Doug Hughes

I was just reading this string and it is great!

1. Our hospital just purchased a program called Policy Tech where in each person has a login and is given a list of required policies to read each year. They are hospital wide so they get 30 days. The "read" is documented based on their login and if they just pencil whip it, well that is on them we are all grown ups I think.

2. I had no idea that an iron maiden was not kosher with HR, what shall I do with mine now?

3. WD40 and superglue? fabulous! We have a tool drawer in there also, with hammers and nails oh and gorilla glue if needed

4. We always re-crossmatch. Has to do with the regulations that we are a transfusion service and the ref lab is not.

Looking for the wise sayings string: " If it ain't broke don't fix it" I love that one.

3. WD40 and superglue? fabulous! We have a tool drawer in there also, with hammers and nails oh and gorilla glue if needed

Oh Lara, you are sooooooooooooo passe!

These days you should be using *****-driver and screws; preferably a Phillips!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

You get far longer lasting and stronger agglutination.

:D:D:D:D

OK L106....where's our "wise sayings" string???

OK, I'll try to figure out how to start a string.

Nothing is 'foolproof', but.....Annual SOP review is tied to our Performance Review tool. I give the techs 2 months to review and sign-off on policy review each year. Anyone who has not completed by the deadline receives a zero for that category in their annual performance review. Last year was the first year that I had techs not complete on-time and I reflected this in their performance. This year everyone completed ahead of schedule. Apparently $ is a motivator

Good idea- i'll give this one a go, I'm sure this will go down like a lead balloon when I state this for then ext APR. Only problem we have is that staff reviews are not properly linked to ££ (yet!), so possibly won't work.

Rashmi, I don't know if this helps or not but our Laboratory implemented a comprehensive document control system as part of our ISO15189 accreditation. We actually purchased a document control software package that we use throughout the Lab (not just in Blood Bank) that requires, documents, and tracks annual staff review of SOPs. It works very well for us.

Doug Hughes

Thanks Doug, we also have a doc control software, but it's not very good and is basically for loading, unloading documents (but not excel spreadsheets!!!) and reminders. So it really comes down to checking the staff sign sheets at the moment.

I give lots of small quizes and also ask questions like, ...what does the procedure say about..., what page is it on? and I give rewards like candy bars or McDonalds gift slips for 5.00 to the people to turn their's in by the deadline and have all correct. I don't care if they help each other because at least they know where the answers are when they need them.

I give lots of small quizes and also ask questions like, ...what does the procedure say about..., what page is it on? and I give rewards like candy bars or McDonalds gift slips for 5.00 to the people to turn their's in by the deadline and have all correct. I don't care if they help each other because at least they know where the answers are when they need them.

Love it! I do similar for those 'annual competencies' but I like this 'spot check' idea! btw: I use Kudos bars for 'good deeds done', aka 'Kudos to ...'

Good for you!

Too much work ... again.

New procedure or revisions: Mini copy is printed and put in a 'New Procedure/Revised Procedure' notebook. Techs are instructed to review and sign off on a review sheet during or prior to their next rotation/shift in BB. btw: For revisions, I highlight the area revised so they don't miss it.

Other than that, why review? Seriously, that's a LOT of data to absorb in one sitting/short period of time! The SOP's are there on the shelf for reference if the techs feel they don't have it memorized (eg 'haven't done this for months!') or a question.

n.b. If there are errors where the tech did not follow the SOP, part of the corrective action is to have the tech re-review the procedure (with appropriate documentation).

+n.b. Annual quizzes (if I choose that route for competency assessment) include questions about those obscure details we tend to forget or info that the techs may have forgotten are there in the SOP's or issues that have come up during the year.

+n.b. New employees make the trek through the SOP and sign off on them as they are 'learned'.

Keeping the techs in the 'know what you don't know' zone is a perpetual task... and it's got to be proactive ... not a 'once a year sit down and run your fingers through the pages, remember it all for the next year, and hand me the sign-off sheet when you are done'.

CAP, etc. requires that the manager (or such) review each procedure at least annually ... this is to make sure the procedures are error free and up-to-date ... THAT makes sense! (I do one section per month so I can focus on the details ...)

I think it is important to check to make sure that they know the stuff they do daily so you can be sure they are following accurately your SOP that they have memorized. For the weird stuff, I want to be sure that they know where to find the SOP when they need it. It isn't important that they have it memorized.

The problem is that people will memorize the stuff they do routinely and then perform it routinely (including their own personal shortcuts), possibly without implementing revisions when you make them, or they will perform the test the way they were originally trained and not the way your SOP states. Widget making (doing the same thing over and over) lends itself to slippage in actual performance.

Too much work ... again.

New procedure or revisions: Mini copy is printed and put in a 'New Procedure/Revised Procedure' notebook. Techs are instructed to review and sign off on a review sheet during or prior to their next rotation/shift in BB. btw: For revisions, I highlight the area revised so they don't miss it.

The SOP's are there on the shelf for reference if the techs feel they don't have it memorized (eg 'haven't done this for months!') or a question.

Yes, we do that too (in fact the new/revised bits are highlighted on all copies, including the master), but we have a Task-based Training Record Sheet that has to be signed off by the trainer, as well as the trainee (part of the Good Manufacturing Practice insisted upon by the EU Blood Directive).

However, once these are all signed off (1 month maximum) the paper copies have to be destroyed and only electronic copies are available. This, apparently, is so old copies cannot be used. The trouble is, of course, that people keep their own photocopies or scraps pf paper as an aide memoire.

The other two problems come when we haven't performed a procedure for ages, and the computer is down, or you can't remember the exact title or document number.

You put in a key word, and about a 1000 documents come up.

:mad::mad::mad::mad::mad: