PETRO-FR.6-Rev.

PHILIPPINE ORTHOPEDIC CENTER

Maria Clara corner Banawe Street, Lourdes, Quezon City

TOTAL QUALITY MANAGEMENT FOR BLOOD SERVICE FACILITIES

DECEMBER 7-9, 2021 / ONLINE VIA ZOOM

I. Objective/s of the Program:

To gain, develop and/or improve the knowledge and capabilities of the blood banks staff in the
quality management system of the Blood Bank section. This encompasses from the Donor
recruitment, selection, retention and care up to releasing of a quality blood product for the
patient. This training also aims to establish a well-coordinated blood transfusion service.

II. Learning Outcomes:

This course was designed to let the learner describe and understand the Quality Management
System as well as the preparation of a well designed quality assurance program through the use of the
quality manual, systematized standard operating procedures as well as well explained work
instructions. It also aims to let the learners identify the different sub-units of the blood banking
system in order to easily address different errors for easy troubleshooting.

III. Learning Summary

In this Total Quality Management training, I was able to learn the following:
 Introduction to Quality in Blood Banking
 The transitional era of paid blood donation up to the creation of the National Voluntary
Blood Services Program which centered the Voluntary Non-remunerated blood donation.
 The associated laws in Blood Banking system which is very important in order to guide
the blood bank staff on its implementing laws and regulations.
 The interconnection of the Blood Bank staff with the society, blood donors and patients
with their clinicians. An important chain to consider in order to maintain harmonious
relationship between the three elements.
 The elements of the quality system which centers the process for proper execution.
 Quality system in Blood Donor Management
 The 3 most important elements are: Donor recruitment and selection, Donor retention
and the Donor counselling and care.
 Donor retention which is the most difficult step in blood donor management. Ideally we
the MTOD should get the feedback from the blood donor on its experience in blood
donation in order to improve the services offered.
 Donor recruitment, selection, pre and post donation counselling
 The objective is to maintain a safety blood supply and quality blood products as well as to
protect the health of the blood donor . This also aims to fulfill the ethical requirement
standards.
 It was also discussed the importance of risk assessment and to further encourage the
blood donor from self exclusion.
 Post donation counseling also covers option for continued care for infected donors and
their families through the help of participating facilities.
 Post donation care should also be done by a trained health professional in order to
handle possible adverse effect of blood donation as well as to prevent any unwanted
events associated with blood donation.
 Unit selection and assessment of transfusion outcome
 Rational use of blood products should be properly explained and practice to prevent
blood product wastage .
 Pre transfusion testing is very important to prevent any transfusion transmissible
infection and it is also required for the part of the medical technologist performing TTI
screening to be updated on the latest techniques as well as clinical information for
possible testing considerations.

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  Component selection including indications should be discussed to clinicians in order to
properly manage the patient as well as prevent blood wastage at the same time.
 Investigation for transfusion reactions is very important and should be done spearheaded
by the HBTC.
 Leukoreduction and Irradiation
 The process and methods for leukocyte reduction and its importance in the blood
transfusion services as well as clinical advantage to lessen possible blood transfusion
reactions.
 Clinical indications for leukocyte reduction
 Hemovigilance
 The surveillance system importance mainly in detection, reporting and investigation of
different events and the prevention of recurrence.
 In order to strategize for hemovigilance incidents, collect, analyze and report data
regarding adverse events among patients and healthcare personnel. It should be
voluntary for both parties, it should also be non punitive as well as confidential.
 Protocols are also important because they provide rules for surveillance and reference
materials for any standard processes in the blood bank.
 Maintain the sets for continuous improvement of the process.
 Documentation
 The process in creation of documents in line with the set international standards.
 Documentation which includes written standard operation procedures, standard work
instructions and quality control procedures. All of these data should be properly filed
accordingly and must be stored accessible for the blood bank staff that will serve as
reference.
 Number one rule: IF IT IS NOT WRITTEN, IT NEVER HAPPENED.
 Biosafety and Biosecurity
 The proper biosafety control measures and proper identification of biorisks.
 Biosaftey is considered as set of principles that are designed to prevent unintentional
exposure to pathogens and toxic agents.
 Helathcare waste managemnt should be reviewed by every staff in order to properly
segregate waste that could possibly harm others in events that it is not observed.
 Critical Control Points in Blood Collection
 The association of failure in standard operation procedure execution and its possible
harm in the process.
 CCP in blood collection are as follow: pre donation checks of material and equipment,
donor identification, donor arm cleansing, venipuncture, blood collection, care of the
donor, handling of donation and samples.
 Any problem with the critical control points will affect the quality of blood product that is
manufactured. That’s why safe blood starts with the medical technologist.
 Quality system in Component Production and Management
 The quality issues in component production and management which includes equipment,
pre processing check, selection of methodology, storage and labeling. It also includes
documentation and quality monitoring.
 All blood components must be prepared using good manufacturing practices, prepared by
well trained staff and it must be safe and effective.
 This also includes properly labeled component and must meet the criteria as per quality
assurance system.
 Blood Cold Chain
 The proper transport and handling of blood products from the time of collection up to the
time that blood unit was transfused.
 In issuance of blood components, first in, first out policy should be properly monitored.
Issue only those blood components that meet release criteria. Perform quality checks on
the blood unit before issuance to prevent mismatched information that can lead to
transfusion related problems.
 Blood Inventory Management
 The interconnection between the blood inventory and the demand of blood.
 The occurence of shortage and its proper identification through the use of biostatistical
analysis.
 Resource Management
 The outlining of the resources which includes human, physical plant, equipment or
instruments, reagents and supplies.
 The importance of each resources and their contribution to the process in quality system
in Blood Bank.
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 Immunohematology and pre transfusion testing
 Different techniques and proper troubleshooting in discrepancies encountered.
 Proper training for the blood bank staff in terms of blood banking procedures. This will
help the blood bank to prevent any unwanted events and properly resolve discrepancies
in any phases of the procedure.
 Transfusion Transmitted Infections
 Different techniques and updates in identification including their clinical outline.
 It should be discussed together with the clinician.
 Current techniques are encouraged to apply in blood banking system to prevent such
Transfusion transmissible infections like nucleic acid testing.
 Incubation periods should also be considered that’s why clinical updates should be
regularly discussed to medical technologists.
 System Audits and Auditing
 The process wherein executed to assure that the quality system is maintained as well as
the ways to improve.

 Audit checklist are set of standards that are ideal for the set up of the blood bank
including its implementing protocols. It is very important this checklist must be observed
at all times in order to maintain the quality system. In order to achieve this, scheduled
section or departmental audit must be done by an auditor from the internal or external
source.

Prepared by:

KAIZEN KIM F. DAMASCO, RMT

Trainee/Participant

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