LCDR Frederick Matheu Applying a DOTMLPF Scorecard to a Blood Safety Program Global Health Engagement 1 Dec 2015 Overall Classification of this Brief is: USPACOM Blood Safety Program Defending Americas Interests in the Indo-Asia-Pacific Lead Rebalance Operationalize Theater C2 Drive Activities in TCO Fight Tonight Organizational Coherence/Climate Defend the Homeland 2 FDO#7778 Disclosures The presenter has no financial relationships to disclose. This continuing education activity is managed and accredited by Professional Education Services Group in cooperation with AMSUS. Neither PESG,AMSUS, nor any accrediting organization support or endorse any product or service mentioned in this activity. PESG and AMSUS staff has no financial interest to disclose. Commercial support was not received for this activity. Defending Americas Interests in the Indo-Asia-Pacific Lead Rebalance Operationalize Theater C2 Drive Activities in TCO Fight Tonight Organizational Coherence/Climate Defend the Homeland 3 FDO#7778 Learning Objectives: At the conclusion of this activity, the participant will be able to: Overview of US PACOM Blood Safety Program Understand how to apply DOTMLPF construct in HA/DR projects Understand how to select Industry/Field benchmark indicators Overview of the US PACOM Blood Safety Assessment Tool Defending Americas Interests in the Indo-Asia-Pacific Lead Rebalance Operationalize Theater C2 Drive Activities in TCO Fight Tonight Organizational Coherence/Climate Defend the Homeland 4 FDO#7778 USPACOM Blood Safety Program Enduring program of Blood Safety in Lao PDR, Vietnam and Cambodia since 2009 Purpose: Builds host nation biosecurity and a sustainable blood program capacity in support of disaster response Brings together civilian and military blood program stakeholders in Partner Nations, paving the way for further civilian and military coordination Program progression to include frozen blood products, nursing training, and link with Blood Bank construction Partners Defending Americas Interests in the Indo-Asia-Pacific Lead Rebalance Operationalize Theater C2 Drive Activities in TCO Fight Tonight Organizational Coherence/Climate Defend the Homeland 5 FDO#7778 Project Overview Blood Safety Systems Blood Donor Selection Blood Collection Infectious Disease Screening Blood Component Manufacturing Compatibility Testing National Guidelines for Blood Administration Adverse Blood Transfusion Events (identification, counseling and treatment) Donor and Recipient notification of positive infectious disease test results Blood Products Recall Equipment and Building Constructions Defending Americas Interests in the Indo-Asia-Pacific Lead Rebalance Operationalize Theater C2 Drive Activities in TCO Fight Tonight Organizational Coherence/Climate Defend the Homeland 6 FDO# Accomplishments Lao P.D.R. Developed a National Blood Administration Guidelines and SOP for Nurses on Blood Transfusion, Identification and Treatment of Adverse Transfusion Events Developed a National Blood Safety Training Team to educate Provinces and Districts Transferred DoD Blood Bank Excess Equipment to support 2016 ASEAN Chairmanship. Lao will host more than 300 international meetings next year Developed Frozen Blood program capability. Lao will receive DoD Frozen Red Cells to support the meetings Cambodia U.S. Whole of Government Approach and International partnership with Australian Red Cross for Policy Development and Infrastructure capacity building Expanding from Lao to Cambodia the National Blood Administration Guidelines and SOP for Nurses on Blood Transfusion, Identification and Treatment of Adverse Transfusion Events Establishment of First Military Hospital based Blood Product Depot (Transfusion Services) Defending Americas Interests in the Indo-Asia-Pacific Lead Rebalance Operationalize Theater C2 Drive Activities in TCO Fight Tonight Organizational Coherence/Climate Defend the Homeland 7 FDO#7778 New Equipment Defending Americas Interests in the Indo-Asia-Pacific Lead Rebalance Operationalize Theater C2 Drive Activities in TCO Fight Tonight Organizational Coherence/Climate Defend the Homeland 8 FDO#7778 Construction Projects Defending Americas Interests in the Indo-Asia-Pacific Lead Rebalance Operationalize Theater C2 Drive Activities in TCO Fight Tonight Organizational Coherence/Climate Defend the Homeland 9 FDO#7778 Assessment Tool Blood Safety Program Goals Builds host nation biosecurity and a sustainable blood program capacity in support of disaster response Increase Host Nation Blood Safety, measured by WHO Guidelines and monitored via DoD Blood Safety Index (BSI). Not FDA Guidelines Develop a program that can be interoperable with U.S. Armed Services Blood Program to support Exercise, HA/DR events and Operations What can U.S. whole of government influence? Doctrine/Policy: Policy Development Organization: Support NBTC Development Training: Train the Trainer approach to develop Blood Safety training teams Materiel: Purchase Blood Safety equipment to build capacity Leadership/Education: Align training with MED/NURSE/Lab schools to develop future generation Personnel: Limited influence. Mentor and provide concepts for improvement Facilities: Work with U.S. Army Corps of Engineers to build WHO approved Blood Centers. Supports application for Global Fund grants Defending Americas Interests in the Indo-Asia-Pacific Lead Rebalance Operationalize Theater C2 Drive Activities in TCO Fight Tonight Organizational Coherence/Climate Defend the Homeland 10 FDO#7778 Sources for Benchmark Points World Health Organization Guidelines Blood Safety Index Analysis Guide AABB Accreditation Guidelines (international accreditation track) Defending Americas Interests in the Indo-Asia-Pacific Lead Rebalance Operationalize Theater C2 Drive Activities in TCO Fight Tonight Organizational Coherence/Climate Defend the Homeland 11 FDO#7778 Blood Safety Program Assessment Tool Capability None End StateMinimalSignificantModerate Doctrine/ Policy No legislation and/or regulatory framework No national standards for manufacturing/admin No quality assurance plan Little specific legislative and/or regulatory framework Developing standards for manufacturing, QA, & admin Partially specific legislative & regulatory framework Developing standards for manufacturing/admin/QA plan Local HV System Specific legislation & regulations Natl blood policy & strategic plan Natl manufacturing/admin standard Established QA plan Regional HV System Compliance with international standards National surveillance & HV System 100% TTI testing Organization No BTC 100% paid donors Hospital/Clinic collection No NBTC/ Transfusion Committee No comp/standardized screening or lookback 75% remunerated donors Developing NBTC, Transfusion Committee Delegation to NGO Developing comp/standardized screening and lookback 50% remunerated donors Have NBTC & Developing RBTC Have Transfusion Committee Have comp/standardized screening Lookback program 25% remunerated donors NBTC tasked with overseeing blood safety, managed by competent clinical authority trained in blood bank with adequate funding 100% voluntary unpaid donors Training No training programNo standardized trng prog No trainers Developing trng program Developing trainers Have a standardized trng program Have trainers Regional training provider Materiel No functional refrigerators No functional centrifuges No testing No PPE 50% sterile connectors Combination of ELISA & rapid testing with confirmatory test Lab coats & gloves only 100% functional refrigerators 100% functional centrifuges 5 expressers per Regl center 2 beds per phlebotomist 100% sterile connectors Elisa testing per Regl center with confirmatory testing Lab coats, gloves, eye protection HIV, HCV, HBV, Malaria, Syphilis testing Leadership & Education None trained in blood safety Not aligned w/technical schools Not aligned w/medical & nursing schools 25% trained blood safety 25% of Regl ctrs aligned w/technical schools 25% of Regl ctrs aligned w/medical & nursing schools 50% trained blood safety 50% of Regl ctrs aligned w/technical schools 50% of Regl ctrs aligned w/medical & nursing schools 80% trained blood safety 75% of Regl ctrs aligned w/technical schools 75% of Regl ctrs aligned w/medical & nursing schools 100% trained in WHO guidelines, blood admin, donor/recipient counseling All Regl ctrs aligned w/schools Personnel Staff works 100 hours/wk No qualified personnel 0% Hep B vaccinated Staff works 75 hours/week 25% qualified personnel 25% Hep B vaccinated Staff works 60 hours/week 50% qualified personnel 50% Hep B vaccinated Staff works 50 hours/week 75% qualified personnel 75% Hep B vaccinated Staff works 40 hours/week 100% graduated from course 100% Hep B vaccinated Facilities 25% WHO design