Maintaining a blood and tissue storage environment that meets regulatory standards for temperature has historically been a never-ending tactical challenge for laboratory staff. Over the years, the process of manually checking and recording temperatures on a recurring basis has been supplemented by standalone data recorders with built-in memory; however, these have their own shortcomings, most significantly the need to consistently download cached information.
The advent of wireless network-based monitoring took the standalone data recorder concept one step further, continually transmitting temperature measurements to a network server. Not only does this approach add a level of redundancy to the solution, but it also centralizes the flow of data, which makes real-time reporting and analysis possible.
Wireless monitoring affords key improvements for the blood bank/blood center, including:
• Optimization of Staff Workflow - Through effective use of automated alerts and reporting, temperature monitoring is handled by exception. This frees up staff to more efficiently handle mission-critical tasks, without the disruption caused by frequent manual checks and recording.
• Trend Discovery and Analysis - Wireless temperature tags are typically configured to measure and send temperature data every few minutes. This level of granularity can expose trends over time, thus potentially warding off the risk to stored materials due to improperly set thermostats or catastrophic equipment failure, through early detection of cyclical problems. The availability
of a data warehouse and analytics component for business intelligence should be a key selection criterion for a progressive solution.
• Audit Readiness and Reporting - Even when an audit is scheduled in advance, the collective level of associated stress can be a major disruption to daily workflow. Having a repository of real-time data available on the server for on-demand reporting can serve to reduce that stress and satisfy auditors' needs expeditiously.
Preparing for a successful wireless monitoring solution deployment requires that the blood bank/center work in close concert with facilities, IT and/or biomedical partners within the organization. Those leading the initiative should be ready to answer these key questions:
• Is My Wireless Environment Ready?
Wireless temperature tags require only a minimal level of wireless coverage to transmit their data; however, IT should be engaged to measure coverage levels at each unit's location to ensure that data will be reliably transmitted. It may be necessary to add or relocate wireless access points to provide this minimal level of coverage.
• Are My Refrigeration Units Ready?
The two primary types of tags are self-contained tags, which reside completely inside the unit, and tags that use an external tag and probe/cable. Self-contained tags require a consistent location for mounting, in the center of the refrigerated mass. Tags with a probe/cable use existing "portholes" for access to the refrigerated space.
• Is My Staff/Policy Ready?
Prior to any deployment going live, workshops with all key impacted staff should be conducted, and the output from this process will include a firm understanding of what happens when an alert occurs and who is responsible for each step.
• How Will Wireless Monitoring Impact My Audits?
It is critical to have scheduled and on-demand reports at the ready. The frequency of report generation, formatting, contents and report recipients should be defined as a key output of the deployment workshops.
Unique Blood Bank/Center Issues
The blood bank faces unique requirements that do not factor into a typical lab environment, and while none of these are insurmountable, they have a real impact on solution planning and design. These include:
• Shelf/Tray-Level Monitoring - Many refrigeration units optimize the use of space by employing a system of multiple pull-out shelves or trays. Temperatures from top to bottom in a unit can vary significantly, so it may be necessary to deploy tags/probes at multiple locations within a single unit.
• Monitoring While in Transport - If blood/tissue is transported among multiple facilities/locations, wireless coverage is not guaranteed or assumed at all points along the way. The ability for a wireless tag to "store and forward" temperature readings taken while in transit is a key consideration when choosing a solution, so that the integrity of storage conditions can be guaranteed/reported from end to end.
• Timeliness of Incident Response/Remediation - The sensitive nature of blood and tissue requires that stringent response policies and related system settings be in effect. This includes a tight threshold for out-of-range alerts, a well-defined workflow around response to such alerts and a requirement for consistent entry of corrective actions taken. The facility needs to ensure adequate space for emergency relocation of unit contents in the event of a failure requiring repair.