There is a small hospital about 10 miles away that is wanting to do away with their blood bank. They want to send their samples to us, we perform the work and then send blood products back to them.

Does anyone do anything similar to this?

My boss and pathologist don't want to touch this.  I don't either.   My boss wants me to find a good reason to say no.

In two words, "major haemorrhage".  That ahving been said, of course, if they have a hot lab..........................................

Tell them that would put your laboratory in a "profit" center.  If your hospital is a non-profit this would not be a good thing.  You can also get into the nitty-gritty of transfusions - tell them that they would have to follow your protocols for everything from patient identification, specimen collection and the Nursing aspects of transfusion.  Who would do a transfusion reaction workup?  Who would save the bag afterward (if you do that)?  You'd have to inspect their process in action . . . (and you would charge them for that).

Is that enough?

In my state (NY) they would have to get licensed as a limited transfusion service.  Very lengthy process, lot of regulations.  I wouldn't want to touch that either.  The only way I would consider it is if they had the Hemosafe system (blood vending machine).  The Puget Sound system uses these for some of their locations.

One word - shipping.   It is complicated, time consuming, fraught with error.   And I agree with all that David wrote.    

In my eyes it's 10 miles away.  Just bring them here! 

We are actually doing it as a part of our reference services for a small neighboring facility, though it's rare they need us for that.  They don't give a lot of blood. Most of the time they send their samples to the blood supplier's reference service. We are in a rural area 3 hours away from our blood supplier. This facility is over an hour away from us - sending samples to 'the big city' for reference service and blood products can add 2+ days to the process of transfusing the patient in a facility like that because they don't have daily access to shipping options to get the samples out and limited options to getting blood products back. If the patient is in serious condition, the patient is going to be transferred, probably to us. We are getting those (rare) samples for the patients that shouldn't wait long for transfusion but aren't in serious enough condition to transfer.

The small towns in our state have a lot of elderly residents and are often a significant distance from towns with larger hospitals so access to medical care is a chronic state-wide problem. There is little public transportation and it can be difficult for patients to find a way to get to larger facilities away from where they live. It can be tricky sometimes for the elderly to get to us when they live here! (There are very creative efforts from the medical community across the state trying to improve access in an ongoing process.)

The small facility lab is expected to crossmatch the unit when they receive it. We routinely transfer blood products to our smaller neighbors, including them, as part of our contract with our blood supplier, so nothing out of the ordinary for that function. We expect to receive a properly labeled specimen and correct/complete orders which include patient information that exactly matches the specimen label or we don't accept the specimen. We do what we can to help in a difficult situation for the benefit of the patient.

Edited February 12, 20169 yr by AMcCord
A new thought.

20 minutes ago, amym1586 said:

In my eyes it's 10 miles away.  Just bring them here! 

At that distance, that would be the best solution if the patient can get to you.

We have a rehab facility next to our building that is not part of our hospital system (its actually part of a much larger hosptial system located about a half hour away) and we have a LTS (limited transfusion service) license from NYS.  We have also done this for a dialysis center next to one of our other hospitals.  We regularly send and provide blood products to other hospitals within our system- we have had no issues with it regulatory or otherwise.   Good luck!  I can't say as I blame you though- its kind of a pain to set up.

Hi Amy,

We are the transfusion service for three hospitals in our area that don't have blood banks.  They follow our blood draw and patient identification requirements, send us the specimen and we perform the type and crossmatch and transfer the blood.  We have contracts spelling out exactly what is required of them, as well as us.   It is their responsibility to arrange for transport of both specimens and RC units.  Two hospitals send the specimen with couriers and someone from their facility will pick up the blood later, while another sends the sample with a hospital employee who then waits "in the Big City" for an hour (usually they shop!) while we get everything ready.  I have never been to any of their hospitals but they are required to send the transfusion paperwork back so I can review and make sure they are following policy for transfusion.  They also have protocol for how to what is needed for a transfusion reaction and we would work it up here.  We have been doing this for many years and no inspectors have questioned the process.  They just want to see the contracts and transfusion documentation.  We are a non-profit hospital.