New Application: Blood Banking/Transfusion Medicine

New Application: Blood Banking/Transfusion Medicine

Review Committee for Pathology

ACGME

Program Personnel and Resources

Other Program Personnel

Brieflydescribe the program coordinator and qualified laboratory technical personnel that will provide support for the clinical, teaching, educational, and research activities of the fellowship. [PR II.C.1.](Limit response to 400 words)

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Resources

Describe the office space, meeting rooms, and laboratory space available to support patient care-related teaching, educational, research activities, and clinical service work. [PR II.D.1.](Limit response to 400 words)

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Will the laboratory have a blood banking/transfusion medicine information system that is approved by the Food and Drug Administration (FDA) for use in blood banking/transfusion medicine?
[PR II.D.3.]...... ☐YES ☐NO

3.Provide the data requested below for each site participating in the program. [PR.II.D.2.]

a)General Data

Site #1 / Site #2 / Site #3 / Total
Crossmatches / # / # / # / # /
Accreditation (AABB, CAP) / Click here to enter text. / Click here to enter text. / Click here to enter text. /
Licensure (FDA, Other (specify)) / Click here to enter text. / Click here to enter text. / Click here to enter text. /
Emergency Room Visits / # / # / # / # /
Neonatal Intensive Care Visits / Level I / # / # / # / # /
Level II / # / # / # / # /
Level III / # / # / # / # /
Open heart procedures / # / # / # / # /
Transplants / Bone marrow / # / # / # / # /
Heart / # / # / # / # /
Kidney / # / # / # / # /
Liver / # / # / # / # /
Other (Specify) / Click here to enter text. / # / # / # / # /
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Is this a regional trauma center? / Choose an item. / Choose an item. / Choose an item. /
Reference lab ARC accreditation rating / # / # / # /
List other specialized facilities / Click here to enter text. / Click here to enter text. / Click here to enter text. /
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b)Donor Facility

Note: These data refer to units prepared on-site at thespecified location.

Site #1 / Site #2 / Site #3 / Total
Donors drawn in facility / # / # / # / # /
Autologous units drawn / # / # / # / # /
Cryoprecipitate / # / # / # / # /
Fresh frozen plasma / # / # / # / # /
Cryopreserved bone marrow / # / # / # / # /
Leukocyte reduced / # / # / # / # /
Packed red blood cells / # / # / # / # /
Platelet concentrates / # / # / # / # /
Leukocyte concentrates / # / # / # / # /
Deglycerolized cells / # / # / # / # /
Stored plasma / # / # / # / # /
Whole blood / # / # / # / # /
Other preparations (specify) / Click here to enter text. / # / # / # / # /
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c)Cell Typing and Serological Studies

Site #1 / Site #2 / Site #3 / Total
ABO typing recipients / # / # / # / # /
ABO typing donors / # / # / # / # /
Alloantibody titers / # / # / # / # /
Antibody identification / # / # / # / # /
Direct antiglobulin test / # / # / # / # /
Crossmatch testing / # / # / # / # /
Flow cytometric crossmatch / # / # / # / # /
Immediate spin crossmatch / # / # / # / # /
Hepatitis Testing / Hepatitis B antigen / # / # / # / # /
Other (Specify) / Click here to enter text. / # / # / # / # /
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HLA Typing / # / # / # / # /
Leukocyte antibodies / # / # / # / # /
HIV Testing / # / # / # / # /
NAT Testing / # / # / # / # /
Mixed lymphocyte cultures / # / # / # / # /
Platelet antibodies / # / # / # / # /
Platelet crossmatch / # / # / # / # /
Rh typing / # / # / # / # /
Type and screen / # / # / # / # /
Other viral serologic tests (specify) / Click here to enter text. / # / # / # / # /
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d)Transfusion Service

Site #1 / Site #2 / Site #3 / Total
Units transfused / # / # / # / # /
Cryoprecipitate / # / # / # / # /
Deglycerolized red blood cells / # / # / # / # /
Fresh frozen plasma / # / # / # / # /
Immune anti-D globulin (# of vials) / # / # / # / # /
Leukocytes / # / # / # / # /
Platelet concentrates / # / # / # / # /
Red blood cells / # / # / # / # /
Whole blood / # / # / # / # /
Washed components / # / # / # / # /
Other (specify) / Click here to enter text. / # / # / # / # /
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e)Other Procedures

Site #1 / Site #2 / Site #3 / Total
Therapeutic leukoreduction / # / # / # / # /
Granulocyte collection / # / # / # / # /
Stem cell collection / # / # / # / # /
Red cell exchange / # / # / # / # /
Photopheresis / # / # / # / # /
Platelet reduction / # / # / # / # /
Therapeutic plasmapheresis / # / # / # / # /
Plateletpheresis collection / # / # / # / # /
Core blood work-ups / # / # / # / # /
Therapeutic phlebotomy / # / # / # / # /
Transfusion reactions investigated / # / # / # / # /
Antibody identifications / # / # / # / # /
Other (specify) / Click here to enter text. / # / # / # / # /
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Fellow Appointments

Number of Fellows

Provide the following information for other educational programs (e.g., other GME programs from this and other sites, residency/fellowship programs for medical technologists, masters and doctoral programs, or post-doctoral programs for clinical scientists) thatuse program facilities for educational experiences in pathology. Add additional rows as necessary.[PR III.B.2.]

Name of Site and Type of Program / Length of rotation
(in weeks) / Maximum number of learners per year / Maximum number of learners present at the same time

Describe the planned interaction of these other learners with your fellows.[PR III.B.2.]

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Educational Program

Patient Care

Indicate the settings and activities in which fellows will demonstrate diagnostic competence in the following. Also indicate the method(s) that will be used to assesscompetence.

Competency Area / Settings/Activities / Assessment Method(s)
Providing appropriate and effective consultation in the context of blood banking/transfusion medicine services, including:[PR IV.A.2.a).(2).(a)]
Blood ordering, blood product indications, and transfusion practices
[PR IV.A.2.a).(1).(a).(i)] / Click here to enter text. / Click here to enter text. /
Cellular therapy
[PR IV.A.2.a).(1).(a).(ii)] / Click here to enter text. / Click here to enter text. /
Donor and patient regulatory issues
[PR IV.A.2.a).(1).(a).(iii)] / Click here to enter text. / Click here to enter text. /
Donor and therapeutic apheresis
[PR IV.A.2.a).(1).(a).(iv)] / Click here to enter text. / Click here to enter text. /
Immunohematology, histocompatibility, and infectious disease testing in donor management, blood component preparation, and blood inventory management
[PR IV.A.2.a).(1).(a).(v)] / Click here to enter text. / Click here to enter text. /
Perinatal, pediatric, transplantation, massive transfusion, and trauma patient care
[PR IV.A.2.a).(1).(a).(vi)] / Click here to enter text. / Click here to enter text. /
Management and direction of a transfusion service and blood center
[PR IV.A.2.a).(1).(a).(vii)] / Click here to enter text. / Click here to enter text. /
Management of patients with special transfusion requirements, such as alloimmunization, hemoglobinopathies, and single or multiple coagulation factor deficiencies
[PR IV.A.2.a).(1).(a).(viii)] / Click here to enter text. / Click here to enter text. /
Peri-operative blood management
[PR IV.A.2.a).(1).(a).(ix)] / Click here to enter text. / Click here to enter text. /
The management and supervision of essential procedures, including:[PR IV.A.2.a).(2).(b)]
Blood management
[PR IV.A.2.a).(2).(b).(i)] / Click here to enter text. / Click here to enter text. /
Collecting blood components, including donor apheresis
[PR IV.A.2.a).(2).(b).(ii)] / Click here to enter text. / Click here to enter text. /
Donor notification, lookback, and component retrieval
[PR IV.A.2.a).(2).(b).(iii)] / Click here to enter text. / Click here to enter text. /
Histocompatibility testing
[PR IV.A.2.a).(2).(b).(iv)] / Click here to enter text. / Click here to enter text. /
Preparing blood components
[PR IV.A.2.a).(2).(b).(v)] / Click here to enter text. / Click here to enter text. /
Selecting and using specific apheresis technologies to ensure appropriate care, clinical management, and safety of patients and donors undergoing apheresis medicine therapies or blood product collection procedures
[PR IV.A.2.a).(2).(b).(vi)] / Click here to enter text. / Click here to enter text. /
Testing blood components
[PR IV.A.2.a).(2).(b).(vii)] / Click here to enter text. / Click here to enter text. /
Therapeutic phlebotomy
[PR IV.A.2.a).(2).(b).(viii)] / Click here to enter text. / Click here to enter text. /
Transfusing blood components
[PR IV.A.2.a).(2).(b).(ix)] / Click here to enter text. / Click here to enter text. /

Medical Knowledge

Indicate the activities (lectures, conferences, journal clubs, clinical teaching rounds, etc.) in which fellows will demonstrate expertise in their knowledge in each of the following areas. Also indicate the method(s) that will be used to assessresident expertise in each area.

Area of Expertise / Settings/Activities / Assessment Method(s)
Adverse effects of blood donation
[PR IV.A.2.b).(1)] / Click here to enter text. / Click here to enter text. /
Adverse effects of blood transfusion, including transfusion-transmitted diseases and non-infectious hazards of transfusion
[PR IV.A.2.b).(2)] / Click here to enter text. / Click here to enter text. /
Alternatives to blood transfusion
[PR IV.A.2.b).(3).] / Click here to enter text. / Click here to enter text. /
Coagulation (hemostasis/thrombosis)
[PR IV.A.2.b).(4)] / Click here to enter text. / Click here to enter text. /
Ethical issues
[PR IV.A.2.b).(5)] / Click here to enter text. / Click here to enter text. /
Red blood cell, platelet, and neutrophil immunology
[PR IV.A.2.b).(6)] / Click here to enter text. / Click here to enter text. /
Scientific basis of transfusion
[PR IV.A.2.b).(7).] / Click here to enter text. / Click here to enter text. /
Selection and recruitment of blood donors
[PR IV.A.2.b).(8)] / Click here to enter text. / Click here to enter text. /
Transplantation, including hematopoietic, solid organ, and tissue
[PR IV.A.2.b).(9)] / Click here to enter text. / Click here to enter text. /

Practice-based Learning and Improvement

Briefly describe one planned quality improvement activity or project that will allow fellows to demonstrate the ability to analyze, improve, and change practice or patient care. Describe planning, implementation, evaluation, and provisions of faculty member support and supervision that will guide this process. [PR IV.A.2.c).(1)] (Limit response to 400 words)

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Briefly describe one example of a learning activity in which fellows engage to develop the skills needed to use information technology to locate, appraise, and assimilate evidence from scientific studies and apply it to their patients' health problems. [PR IV.A.2.c).(2); IV.A.2.c).(5)] (Limit response to 400 words)

The description should include:

Locating information
Using information technology
Appraising information
Assimilating evidence information (from scientific studies)
Applying information to patient care

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Briefly describe how fellows willincorporate formative evaluation feedback into daily practice. (If a specific tool is used to evaluate these skills, have it available for review by the site visitor.) [PR IV.A.2.c).(3)] (Limit response to 400 words)

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Briefly describe one learning activity in which fellows will demonstrate competence in educating donors, patients, families, students, residents, and other health professionals and community members. [PR IV.A.2.c).(4)] (Limit response to 400 words)

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Interpersonal and Communication Skills

Briefly describe one learning activity in which fellows demonstrate competence in providing appropriate and effective consultations to other physicians and health professionals, both intra- and inter-departmentally. [PR IV.A.2.d).(1)] (Limit response to 400 words)

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Briefly describe one learning activity in which fellows demonstratecompetence in their ability to communicate effectively, both verbally and in writing, with donors, patients, families, and the public, as appropriate, across a broad range of socioeconomic, educational and cultural backgrounds, and with physicians, other health professionals, and health-related agencies. [PR IV.A.2.d).(2).(a)-(b)] (Limit response to 400 words)

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Briefly describe how fellows will be provided with opportunities to maintain comprehensive, timely, and legible medical records. [PR IV.A.2.d).(3)] (Limit response to 400 words)

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Professionalism

Briefly describe the learning activity(ies), other than lecture, by which fellows demonstrate a commitment to carrying out professional responsibilities and an adherence to ethical principles. [PR IV.A.2.e)] (Limit response to 400 words)

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Briefly describe one learning activity, other than lecture, by which fellows demonstrateintegrity, an understanding of cultural diversity of patients and donors, and respect for the privacy and autonomy of patients and donors.[PR IV.A.2.e).(1)] (Limit response to 400 words)

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Systems-based Practice

Describe the learning activity(ies) through which fellows demonstrate an awareness of and responsiveness to the larger context and system of health care, as well as the ability to call effectively on other resources in the system to provide optimal health care, specifically how fellows will demonstrate the ability to: [PR IV.A.2.f)] (Limit response to 400 words)

Competency Area / Settings/Activities / Assessment Method(s)
Work effectively in a variety of health care delivery settings and systems relevant to pathology
[PR IV.A.2.f).(1)] / Click here to enter text. / Click here to enter text. /
Advocate for quality patient care and optimal patent care systems
[PR IV.A.2.f).(2)] / Click here to enter text. / Click here to enter text. /
Comply with regulatory and accreditation requirements for blood banking/transfusion medicine, including those of the FDA, the American Association of Blood Banks, the College of American Pathologists, and the Joint Commission
[PR IV.A.2.f).(3)] / Click here to enter text. / Click here to enter text. /
Contribute to quality improvement projects, quality assurance audits, and quality management of transfusion and donor center services
[PR IV.A.2.f).(4)] / Click here to enter text. / Click here to enter text. /
Coordinate quality and safety for donors and patients within the health care system relevant to blood banking/transfusion medicine
[PR IV.A.2.f).(5) / Click here to enter text. / Click here to enter text. /
Incorporate cost considerations and risk-benefit analysis in patient and population-based care
[PR IV.A.2.f).(6)] / Click here to enter text. / Click here to enter text. /
Participate in identifying system error and implementing potential systems solutions
[PR IV.A.2.f).(7)] / Click here to enter text. / Click here to enter text. /

a)If applicable, describe other fellow learning activities related to Systems-Based Practice (limit response to 400 words).

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Curriculum Organization and Fellow Experiences

Outline how clinical experience will include supervision of trainees and/or laboratory personnel, and graded responsibility, including independent diagnosis and decision making. [PR IV.A.3.a).(1)]

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Outline the educational activities specific to blood banking/transfusion medicine, review of the medical literature in the subspecialty area, and use of study sets of unusual cases. [PR IV.A.3.a).(2)](Limit response to 400 words)

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Briefly describe how fellows will participate in ongoing clinical consultations. [PR IV.A.3.b)](Limit response to 400 words)

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Briefly describe how fellows will participate in the interpretation of laboratory data as part of patient care decision making and patient care consultation? [PR IV.A.3.c)](Limit response to 400 words)

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Describe how fellows will be provided with direct responsibility, with appropriate supervision, to make decisions in the laboratory. [PR IV.A.3.d)](Limit response to 400 words)

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List the planned didactic schedule, including blood banking/transfusion medicine conferences, journal clubs, and joint conferences for fellows. Add additional rows as necessary [PR IV.A.3.e)]

Type of session / Frequency / Responsible Department / Required?
(Yes/No) / Attendance Taken?
(Yes/No)

Describe fellow participation in these conferences. How much responsibility will they have for their preparation and presentation?[PR IV.A.3.e).(1)](Limit response to 400 words)

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Blood Banking/Transfusion MedicineUpdated 6/2016