HGH Rotation Objectives Updated June 11, 2014 Key Portfolio Outcomes: Markers: Description: 1.1 Manage the transfusion needs of a complex patient Develop a repository of cases that can be used by you and other trainees. Complex transfusion case presentations illustrating a. Complex antibodies b. Autoimmune hemolytic anemia c. Obstetrical complications d. Platelet refractoriness e. Red cell genotyping f. Transfusion support of bone marrow and stem cell transplant g. Pediatric transfusion issues structured oral examination involving a complex transfusion case Submit one clinical case presentation for each of the complex cases presented; attach supporting materials such as PowerPoint presentations The structured oral exam that is usually given by the attending physician; use one of the complex cases developed for the structured oral exam; provide a list of the questions asked and sign off that the candidate 1.2 Supervise and interpret immunohematology testing Residents should meet with the Senior technologist (Veronica) regularly (e.g. daily) to address routine and complex issues. Antibody lab reports, signed off by supervisor, including: a. RBC (5) (rare and HDFN) b. HLA (1) c. Platelet-antibodies (1) (NAIT) d. ABO discrepancy (3) e. Rh discrepancy (3) ITER documenting achievement of competence in the medical direction of the Transfusion Service (must document both adult and pediatric exposure, as one or two separate ITERs) Submit a total of 13 deidentified lab reports or a mock-up of a report; specified cases and numbers of each are shown in the markers column; use the Royal College Transfusion Medicine template for lab reports; supervisor sign off for each report Submit one ITER for the Transfusion Service; if pediatric and adult experiences are separate, two ITERS are required; use the Royal College ITER template
Key Portfolio Outcomes: Markers: Description: 2.3 Manage the administrative and technical aspects of effective laboratory function 2.4 Evaluate a laboratory s quality management system SJH, HGH (Sandra Fazari), Longitudinal Activities - QMPLS Mtgs in TO, MUMC, JHCC, CBS Satisfactory completion of a report describing the validation of a new laboratory procedure or instrument multi-source feedback assessment of supervisory competencies related to the transfusion laboratory, including input from technologists, attending physician, and management team structured examination related to administrative aspects of laboratory function one case report related to a quality issue, including a strategy to address the quality issues arising one report related to external proficiency testing, including a strategy to deal with any discrepancies one root cause analysis and corrective action preventative action (CAPA) of a real or simulated case related to blood safety (such Write a report describing validation of a procedure or instrument; sign off by a supervisor Using a multisource feedback tool, collect feedback from technologists, managers, attending physicians and management team of supervisory skills of the transfusion laboratory The structured examination completed at the blood centre comprised of both written (take home exam) and oral components will relate to technical aspects of laboratory management; sign off by the blood centre manager on successful completion of the structured examination Submit one case report related to a quality issue Submit one report dealing with an external proficiency testing case; the written report includes the testing, reporting and addressing of any issues on receipt of the report Submit one root cause analysis and CAPA The structured examination completed at the blood centre
as wrong blood to wrong patient) one structured examination relating to quality control issues comprised of both written (take home exam) and oral components will include issues related to quality control issues within the laboratory; sign off by the blood centre manager on successful completion of the structured examination Key Portfolio Outcomes: Markers: Description: 3.1 Serve as an effective consultant for clinical services requiring blood management for individual patients All Clinical Sites Integrate with the hematology clinical team while on rotation at HGH. Collection of at least one deidentified case summary related to each of the following, including details of the blood used, relevant investigations, conclusions, recommendations, and reflection on the case: a. Massive transfusion (e.g. complete an assessment of the massive transfusion protocol from start to finish) b. Sickle cell c. Inherited bleeding disorders d. Transfusion support of bone marrow or solid organ transplant e. Reversal of anticoagulant f. Urgent consultation relating to bleeding g. Inappropriate blood order structured examination related to blood management for individual patients Submit one case summary or consult for each of the complex cases presented The structured exam can either be an oral exam administered by the attending physician or a written/take home exam; provide a list of the questions asked and sign off that the candidate
3.3 Supervise the process of obtaining informed consent for the provision of blood products for patients MUMC,HGH,SJH structured oral assessment related to informed consent for the provision of blood A structured oral exam administered by the attending physician; use a challenge case such as a Jehovah s Witness or underage person who does not want to be transfused;provide a list of the questions asked and sign off that the candidate Key Portfolio Outcomes: Markers: Description: 3.4 Manage the appropriate utilization of blood products HGH, Longitudinal Activities, CBS An audit of blood utilization in a given context, including an analysis of any variance with current clinical practice guidelines An updated clinical practice guideline related to utilization of blood to address the findings of an audit A report for a Transfusion Committee related to an issue of appropriate utilization of blood in a hospital, indicating when it was presented to the Committee Submit one audit or report related to use or adaptation of a clinical practice guideline related to utilization of blood for a hospital or a certain patient group
3.5 Develop and implement blood conservation strategies CBS, HGH (contact Sophie Stouth RN ONTraC Blood Conservation Coordinator Hamilton Health Sciences Perioperative Clinic Rm 2P4, MUMC Site Tel: 905 521-2100 ext. 75836 Fax: 905 521-5058 stouth@hhsc.ca) At least one de-identified preoperative consultation simulated case involving blood conservation techniques, including details of the blood used, relevant investigations, conclusions, recommendations, and reflection on the case Completion of a structured oral examination related to blood conservation strategies Submit one pre-operative consultation or simulated case report involving blood conservation techniques A structured oral exam administered by the attending physician relating to blood conservation strategies; provide a list of the questions asked and sign off that the candidate 4.1 Manage the supply of blood 5.2 Advise on the quality of manufactured blood products and components a structured examination related to inventory management, outdating and wastage audit related to inventory management, outdating and wastage current Good Manufacturing Practice (cgmp) training n ITER documenting achievement of competence in component suitability The structured exam can either be an oral exam administered by the attending physician or a written/take home exam. Provide a list of the questions asked and sign off that the candidate. Or Submit one audit related to inventory management, outdating and wastage. cgmp training will be conducted at the blood centre; the blood centre manager will sign off on completion of the training Submit one ITER documenting achievement of competence in component suitability achieved on the Blood Centre Rotation
7.1 Contribute to the effective functioning of an inter-professional committee related to transfusion medicine, Longitudinal Activities 7.2 Educate other physicians, other health professionals, members of the public, and government officials about aspects of transfusion medicine Satisfactory completion of a multi-source feedback assessment of contributions to an interprofessional committee related to transfusion medicine a reflective report describing interactions with governmental or regulatory officials Satisfactory completion of a multi-source feedback assessment of contributions to a committee which includes governmental or regulatory officials an ITER documenting effective contribution to a governmental or regulatory committee related to transfusion medicine Submission of a teaching dossier demonstrating at least two effective presentations (as evidenced by formal participant evaluation) related to transfusion medicine for at least two of the preceding groups Using a multi-source feedback tool, submit assessment of contributions to an inter-professional committee to a committee which includes governmental or regulatory officials Submit one ITER documenting effective contribution to a governmental or regulatory committee. Submit a teaching dossier for at least two effective presentations for at least two of the following groups (physicians, other health professionals, members of the public and government officials) 8.1 Conduct or contribute to a research project related to transfusion medicine MUMC, SJH, JHCC, HGH, Research, CBS Submission of an abstract or completed manuscript Submission of a research proposal or grant application Submit an abstract or manuscript Submit a research proposal or grant application Submit a progress
Submission of a progress report of their research project Satisfactory completion of an ITER documenting their achievement of competence in conducting or contributing to a research project related to transfusion medicine Submission of an satisfactory evaluation of a presentation of one critically appraised article presented at a transfusion medicine related journal club report of a research project. Submit one ITER documenting achievement of competence in conducting or contributing to a research project. Submit an evaluation of a presentation or critically appraised article presented at a journal club. NAME ROLE Email Ted Warkentin Rotation Supervisor twarken@mcmaster.ca HGH Site, Room 1-180D X46139 Menaka Pai Teaching Staff mpai@mcmaster.ca HGH Site, Room 1-270A Sandra Fazari Julie DiTomasso TM Technical specialist (operations) TM Technical specialist (safety) X46139 fazari@hhsc.ca HGH X46465 ditomassoj@hhsc.ca MUMC Room 2N50 X73732