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© America’s Blood Centers All rights reserved.

ABC Appropriate Inventory Management September, 2011 of 37

Hospital User Guide Module I

Table of Contents

Purpose 3

Requirements for Hospital Automated Data Loads 3

Create Files for FTP Upload 3

Hospital File One: Hospital Issuable Inventory 4

Hospital File Two: Hospital Allocated Inventory 4

Hospital File Three: Hospital Wastage 5

Hospital File Four: Hospital Transfusions 6

FTP Upload Transfer of Hospital Data Files 6

AIM Web Access 7

Creating a Shortcut on Desktop 8

Training Courses 8

Accessing the System 8

Home Page Menu Bar 11

Home Page-Messages 13

Home Page-Blood Center Inventory Figures 14

Home Page-Hospital and Center Fields 14

Hospital Data Entry: Edit Daily inventory 14

Ideal Inventory 16

One-Day of Inventory 16

Days Worth of Inventory 16

Blood Product Wastage 16

Wastage Categories 17 Service Line Categories 17

Service line Monthly Totals 18

Wastage as a Percentage of Net Units Distributed(WAPD) 18

Allocated Inventory 19

Inventory Transfers 19

Transfused Data Entry 20

View Hospital Graphs 21

Detailed Graph Page 24

Available Data Sets 25

View Hospital Data 27

The Date Field 28

Reports with Hyperlinks to Data Entry Pages 28

Choosing the Data Set 29

Forms 31

Hospital Profile 31

Contact Form: Hospital Information 33

Request Update of Hospital Transfer 34

Hospital Automated Data Loads File Creation Checklist 35

Glossary 37



Purpose Appropriate Inventory Management (AIM) is a data management software tool for blood product inventory management and blood utilization analysis. America’s Blood Centers (ABC) hosts the software and the data in the ABC Data Warehouse. ABC provides access to AIM for the hospital transfusion services supplied by ABC members. Hospitals access AIM through ABC member blood centers.

The AIM software provides hospital transfusion services and blood centers with the data they need to monitor:

� Inventory management, and;

� Blood utilization review for transfusion services.

Requirements for Hospital Automated Data Loads (ADL) Beginning with module I of the AIM I software, participating blood centers can offer their hospital clients an automated process for sharing their issuable inventory, allocated inventory, wastage experiences, and transfusion experiences.

The blood center's FTP account is 'write only'. Therefore, the blood center will share their FTP account credentials with their AIM participating hospitals. The hospital will directly transfer their files using the blood center's FTP account.

The hospital files should be uploaded to the FTP account by 1:00AM PST, 2:00AM MT, 3:00AM CST, and 4:00AM EST.

Create Files for FTP Upload

A total of four files are needed to automate the hospital's module I data to the AIM software. The four data files referenced below have standard formatting to include: Extraction from your inventory system in ASCII mode, tab delimited, with or without column headers, null values are not included for product groups, ABO/Rh, or product counts. The FTP account is 'write only'. Therefore, files should be placed onto the FTP account.

Note : Only undivided blood product units should be entered into AIM, as AIM does not currently monitor pediatric units that have been divided into aliquots.

The Hospital Automated Data Loads File Creation Checklist is available on page 35 of this document.

The blood center should work with your hospital client to validate the information included in the following files as accurate and properly formatted prior to submitting.

The four hospital data files are:

� Hospital Issuable Inventory;

� Hospital Allocated Inventory;

� Hospital Transfusions, and;

� Hospital Wastages.

Instructions:

Step 1

� Provide the Hospital Code (blood center's accounting code) defined in AIM and provide to the ADL participating hospital.

Step 2

� Map all product codes to available product groups.

o 1-Red Blood Cells;

o 2-Leuko (reduced) Red Blood Cells;

o 3-FFP;

o 4-FFP >400mL;

o 5-Cryoprecipitate;

o 6-Pooled Cryoprecipitate;



o 7-Whole Blood Platelets;

o 8-Whole Blood Platelets, Pooled and;

o 9-Apheresis Platelets.

Note : Your blood center has mapped the product codes that are distributed from their center to the product groups that are defined in AIM. You can request the mapped product code spreadsheet from your blood provider. If your hospital or blood center produces ABO Pooled Rh components, please include these pooled Rh products under the Rh Positive ABO equivalent.

Step 3

� Hospital creates files for FTP Upload.

Hospital File One: Hospital Issuable Inventory

Each day, hospitals count their available inventories (all product groups) following the release of allocated (cross-matched) components and prior to the receipt of the daily routine shipment.


Instructions:

File Name: HospitalIssuableInventory.HospitalCode.MMDDYYYY .txt

Step 4

� Create Hospital Issuable Inventory File

FullFacilityCode: Varchar (20) HospitalCode from Step 1 appended to Blood Center's Facility Identification Number (FIN).

ProductGroup: Varchar (2) –1 = Red Blood Cells; 2 = Leuko (reduced) Red Blood Cells; 3 = FFP; 4= FFP >400mL; 5 = Cryoprecipitate; 6 = Pooled Cryoprecipitate; 7 = Whole Blood Platelets; 8 = Whole Blood Platelets, Pooled and; 9 = Apheresis Platelets.

BloodGroup: Varchar (6) (‘ O Pos’, ‘ O Neg’, ‘ A Pos’, ‘ A Neg’, ‘ B Pos’, ‘ B Neg’, ‘AB Pos’ and, ‘AB Neg’)

ProductCount: (Numeric) Total Number

Example:

Hospital File Two: Hospital Allocated Inventory

Each day, hospitals count their allocated (cross-matched) inventory of red blood cells and/or leuko (reduced) red blood cells following the release of allocated components for which the cross-match has expired.


Instructions:

File Nam e: HospitalAllocatedInventory.HospitalCode.MMDDYYYY.txt

Step 5

� Create Hospital Allocated Inventory File


ProductGroup: Varchar (2) – 1 = Red Blood Cells; 2 = Leuko (reduced) Red Blood Cells





Example:

Hospital File Three: Hospital Wastage

Unlike the inventory and allocated files, hospitals can schedule the script to extract wastage experiences either daily or monthly. If monthly data extraction is scheduled, the date of the wastage file should be the last day of the month for which data is included.

Instructions:

File Name: HospitalWastage.HospitalCode.MMDDYYYY.txt

Step 6

� Create Hospital Wastage File

Note: Autologous units are captured here in aggregate.


ProductGroup: Varchar (2) – 1 = Red Blood Cells; 2 = Leuko (reduced) Red Blood Cells; 3 = FFP; 4= FFP >400mL; 5 = Cryoprecipitate; 6 = Pooled Cryoprecipitate; 7 = Whole Blood Platelets; 8 = Whole Blood Platelets, Pooled and; 9 = Apheresis Platelets.

ServiceLine: Varchar (2) - 0 = None Selected; 1 = Blood Bank; 2 = Medical Services; 3 = Neonatal Services; 4 = Surgical Services; 5 = Bone Marrow Transplant Services; 6 = Obstetric Services; 7 = Solid Organ Transplant Services; 8 = Cardiology Services; 9 = Neurological Services; 10 = Orthopedic Services; 11= Nephrology Services; 12 = Hematology/Oncology Services; 13 = Radiology Services; 14 = Emergency Services and; 15 = Intensive Care Unit Services.

WastageCode: Char (5); IMPCM: Improper Communication; Failure to inform laboratory of cancelled blood orders, patient demise, or improper ordering (e.g. wrong component requested); IMPHA: Improper Handling; Storage of blood units inappropriate (e.g. left at room temperature beyond allowable limits); BKBIG : Breakage/Bag Integrity; Blood unit integrity is lost due to improper spiking or bag leakage due to material failure; PTNRD: Patient Not Ready; Blood unit prepared and/or issued before the patient is ready for transfusion (e.g. IV line not available); CANRX: Cancelled Order; Blood unit obtained or prepared before order was cancelled. If cancelled before blood unit is obtained or prepared and lab not notified, document as IMPCM; PTEXP: Patient Expired; Patient expires after blood unit is prepared. If patient expires before blood preparation and lab not notified, document as IMPCM; EQPFL: Equipment Failure; failure of equipment used for storage, processing, or transport of blood products; OUTD: Outdated; product expired and; FVINP: Failed visual inspection.

BloodGroup: Varchar (6) (‘ O Pos’, ‘ O Neg’, ‘ A Pos’, ‘ A Neg’, ‘ B Pos’, ‘ B Neg’, ‘AB Pos’, ‘AB Neg’ 'Auto')


WastageDate: Char (8) MMDDYYYY

Example:



Hospital File Four: Hospital Transfusions

Like the wastage files, hospitals can schedule the script to extract transfusion experiences either daily or monthly. If monthly data extraction is scheduled, the date of the transfused file should be the last day of the month for which data is included.

Instructions:

File Name: HospitalTransfusions.HospitalCode.MMDDYYYY.txt

Step 7

� Create Hospital Transfused File

Note : Autologous units are captured here in aggregate

Note : 1=Blood Bank is not applicable for transfusion data collection.



ServiceLine: Varchar (2) - 0 = None Selected; 2 = Medical Services; 3 = Neonatal Services; 4 = Surgical Services; 5 = Bone Marrow Transplant Services; 6 = Obstetric Services; 7 = Solid Organ Transplant Services; 8 = Cardiology Services; 9 = Neurological Services; 10 = Orthopedic Services; 11= Nephrology Services; 12 = Hematology/Oncology Services; 13 = Radiology Services; 14 = Emergency Services and; 15 = Intensive Care Unit Services.



TransfusionDate: Char (8) MMDDYYYY

Example:

Step 8

� Once all files are created, blood centers should arrange to receive the files for review. Blood Centers should determine that the hospitals' files have standard formatting which includes: Extraction from the inventory system in ASCII mode, tab delimited, with or without column headers, and null values are not included in a data row.

FTP Upload Transfer of Hospital Data Files Once the blood center validates the format and content, the blood center will provide hospital clients with the FTP account credentials for their account. The FTP account is 'write only'. The purpose of ‘write-only’ is for blood centers to share their credentials with their hospital clients that are interested in participating with automated data loads. Therefore, files should be placed onto the FTP account.

Instructions:

Step 1

� Open the start menu, click on ‘Run’.



Step 2

� Type explorer <ftp://aim.americasblood.org> in prompt and click OK.

Step 3

� Enter provided username and password when prompted (if no prompt comes up, click on File menu > ‘Login as’). Once logged in, place files in the folder.

AIM Web Access AIM is web-based, easy-to-use software that allows the user to input data as well as utilize the data analysis tools effectively.

� The Appropriate Inventory Management (AIM) software should be accessed via yourbloodprovider.org. The URL location and instructions for accessing the AIM software are supplied by your blood center.

� If you experience difficulty accessing the website:

⇒ The firewall or Internet gateway may be restricting access to the site, so your first point of contact should be your hospital IT department, or;

⇒ Your hospital may have limited Internet bandwidth which can reduce the number of calendars that can be displayed, the file size, and the speed the file loads.

⇒ If you fail to get a successful resolution to the problem from your IT group, please notify your AIM contact at your blood center or the AIM Administrator via the support link on the login page.

Instructions:

Step 1

� First, launch a web browser.

Note : All development work with AIM was performed using Internet Explorer, although other web browsers (such as Mozilla Foxfire) may be compatible with AIM. The access instructions below assume you are using Internet Explorer.

Step 2

� In the address box of the browser, type the appropriate Internet address of your blood center and then click the 'Go' button or hit 'Enter'.

� Alternatively, you can click the 'File' option and select 'Open'.



� This opens a dialogue box, into which you type the web address.

Creating a Shortcut on Desktop With your blood center home page displayed:

� Select the 'Favorites' option followed by ‘Add to Favorites’;

� Then, select your blood center’s website option from your favorites list;

� Right click and select ‘Send To’ from the next pop-up, and;

� Select ‘Desktop’ (create shortcut).

Training Courses

Training courses will be offered on a monthly basis. Please contact your blood center representative to request AIM 101 or AIM for VIPs training for the use of the AIM software.

� AIM 101 is a basic software familiarization course intended for those new to the AIM software. This course will cover accessing the software and data entry for available inventory, allocated inventory, wastage and transfusion.

� AIM for VIPs training is targeted at transfusion laboratory managers and other senior staff. These training sessions focus on the data extraction functionalities of the software, and will assist with utilizing the AIM software to maximize the benefits realized from the reporting functions.

Accessing the System Once your hospital expresses interest in participating with AIM, the 'AIM Hospital Profile' form is provided to the hospital representation for completion. The profile identifies the hospital's ideal inventory levels for each blood product, bed size, type of hospital, services provided, distance from the blood center, red blood cell product annualized usage, and apheresis platelet annualized usage, From the hospital profile information, your hospital will be added to AIM by your blood center.

After the initial profile is completed, if changes occur that affect your inventory levels or the level of services that your facility provides, please complete a new 'AIM Hospital Profile' and submit this form with your updated information to your blood center. Once your hospital has been added to AIM, your blood center will then add hospital users. The hospital will be asked to complete 'AIM Contact Form: Hospital Information' to identify the individuals at your facility that will need access to the AIM software.

When a user is added:

� An email containing your user ID and password will be sent to your email address;

� A hyperlink to the AIM login page will be included within the initial email to enable you to gain entry, and;



� Once you have successfully logged in, you must reset your password.

� Forgotten Password? This hyperlink is provided on the login page and will generate an email containing a new password to the mail account associated with the user in the event your password has been forgotten.

Instructions:

Step 1

� Hospital completes 'AIM Hospital Profile'. See page 31 for this form.

Step 2

� Hospital completes “AIM Contact Form: Hospital Information’. See page 33 for this form.

Step 3

� Blood center user defines hospital in AIM based on the information taken from the completed 'Hospital Profile’ form.



Step 4

� Blood center user creates hospital users based on the information taken from the completed 'AIM Contact Form: Hospital Information'. .

Step 5

� An email containing the user ID and password will be sent to the email address provided. A hyperlink to the AIM login page is included within the initial mail.

Step 6

� By clicking the hyperlink within the initial mail, users are taken to the AIM login page.

� Enter the User Name and Password provided and click “Log In”.

Note : These entries are case sensitive.

Step 7

� This will automatically take you to the “Change Password Window” to reset your new password. Please create a new password to prevent unauthorized access to the system.

� In the “Password” field, enter the current password provided by the System Administrator.

Note : Due to the length and complexity of the initially assigned password, please copy the password from the mail notification and paste it into this area.

� Enter the new password in both the “New Password” and “Confirm New Password” fields.

Note : The new password must have a minimum length of 7 characters, and a minimum of 1 non-alphanumeric character (e.g. a symbol).

� Click “Change Password” button.



Step 8

� Once your new password is successfully entered twice, the below message is displayed. The password for this user account has been changed and can be used immediately.

Step 9

� Click on “Continue” to verify and change contact information as needed.

Once you verify your details, select submit and log out of the AIM system to completely update your account. Then, log back into AIM with your user name and new password to begin using the software.

� Forgotten Password?

If you have forgotten your password after your access has been previously processed, simply click the ‘Forgotten password?’ feature and the screen shown below will then appear.

� Enter 'User Name'.

� Click on 'Submit'.

Home Page Menu Bar

The icons contained within the home page menu bar allow the user to navigate from one page in AIM to any other page simply by clicking on the relevant icon. Letting the cursor hover over any of the icons displays a list of products available for data entry. The name of the logged-in user is also displayed.

The ‘Edit’ and ‘View’ menu can also be used to navigate around the site, hovering on any of the options results in pop-ups appearing offering the next level of options.



In the illustration below, the cursor was held over the ‘Edit’ option, resulting in a pop-up appearing with nine further options:

� Red Blood Cells;

� Leuko (reduced) Red Blood Cells;

� FFP;

� FFP >400mL (i.e., “jumbo” plasma units);

� Cryoprecipitate;

� Pooled Cryoprecipitate;

� Whole Blood Platelets (individual units);

� Pooled Whole Blood Platelets, and;

� Apheresis Platelets.

By hovering over the 'Leuko (reduced) Red Blood Cells’ option, the final list of options appears. Selecting any one of these will take you directly to the appropriate data entry page.

Instructions:

� Home

� Navigate from 'Edit' menu.

� Navigate from 'Edit Daily Inventory' Icon.

The ‘Home’ icon takes you back to the home page from any function.

The ‘Edit Daily Inventory’ icon allows the hospital to manually enter or view electronically submitted daily inventory figures for all product groups.

The ‘Allocated Inventory’ icon allows the hospital to manually enter or view electronically submitted daily allocated inventory for red blood cells and leuko (reduced) red blood cells.

The ‘Wastage’ icon allows the hospital access to manually enter or view electronically submitted wastage experiences for all product groups either daily or monthly. .



The ‘Transfers’ icon allows the hospital to enter blood product transfers to other hospitals defined in the AIM software.

The ‘Transfused’ icon allows the hospital access to manually enter or view electronically submitted transfusion experiences for all product groups either daily or monthly.

The ‘View Hospital Graphs’ icon allows access to the graph function for all product groups. The available graphs include:

� Wastage as a Percentage of Units Distributed to the Hospital (Bar) WAPD;

� Wastage as a Percentage of Units Distributed to the Hospital (Line) WAPD;

� Percentage ABO of Total Received;

� Days Worth of Inventory;

� Total Quantity Received;

� Inventory Age at Receipt, and;

� Transfused as a Percentage of Units Received.

The ‘View Hospital Data’ icon allows access to additional reports for all blood products:

� Inventory Level;

� Wastage;

� Gross Units Distributed to the Hospital;

� Net Units Distributed to the Hospital;

� Transfers Between Hospitals;

� Transfused, and;

� Allocated.

Admin

� ‘My Details’

� Change contact information as needed.

Help

� 'Hospital User Guide'

Home Page-Messages

The messages area on the AIM home page shows all messages that have been sent to the current user by the AIM

team. Unread messages are displayed in bold with a grey . Read messages are in regular type with a red .

Clicking on the message title opens a new window displaying the relevant message. It is important that you check this area from time to time, as this is one of the main ways we use to pass new information on to the AIM users. Messages can be deleted once read by left clicking the red arrow.



‘Messages’ from the AIM team are displayed.

Home Page-Blood Center Inventory Figures

Your blood center’s red blood cells, apheresis platelets, and leuko (reduced) red blood cells inventory levels are displayed for the current day and previous ninety days, both in numerical and graphical format on the bottom part of the home page.

This data is populated from inventory information provided by your blood center and is a snapshot of the daily inventory.

As the disclaimer found at the bottom of the page indicates, “This inventory information is not intended to be used for influencing orders. The figures capture a moment in time and do not reflect ongoing availability”.

‘Blood Center Inventory’

Home Page-Hospital and Blood Center Fields

The hospital name and blood center automatically default to your hospital and to your hospital’s assigned blood center. However, if your hospital has permission to “View Only” or “Edit & View” other hospitals’ data, the assign key can be clicked on, which will show a pop- up box. Left clicking on one of the displayed hospitals will select it.

'Assign' key is available if you have privileges for another hospital.

To activate this feature you must first complete an agreement to allow others to access your data.

� The ‘Share Data Agreement’ can be provided to you by your blood center.

� The agreement must be signed by each hospital’s leadership prior to your ability to access this function.

� This feature is particularly useful for those hospitals that have entered into inventory transfer relationships with other hospitals and for those hospitals whom are members of a hospital system.

Hospital Data Entry: Edit Daily Inventory Overview

The hospital transfusion service manually enters, overwrites, or views the electronically submitted available inventory by product group within this function. A typical daily 'Issuable Inventory' data entry screen is shown below. Note how the icon options, 'Edit', and 'View' menus are still shown.



Please refer the above screenshot:

1. The first thing to notice is that there are three types of fields that you are able to enter data and they are all colored white. The fields are ‘Date’, ‘Issuable Inventory’, and ‘Comments’.

Note : The issuable inventory is the number of unreserved, undivided units available for cross-matching or allocating to your patients. Note that only undivided blood product units should be entered into AIM, as AIM does not currently monitor pediatric units that have been divided into aliquots.

The data should be collected after inventory de-reservation (cross-matches/allocated units released), and before the main order of the day is received with your blood center. If that time is inconvenient for entering data make a written note and then enter the data at a more convenient time.

2. The hospital name field defaults to the name of your hospital.

3. AIM defaults to the current date, but this can be changed by:

� Typing the required date into the field below the hospital name (use mm/dd/yyyy format);

� Clicking the left mouse button on the appropriate days date in the calendar strip, or;

� Clicking the ‘Show Calendar’ button which opens a 12-month calendar in a new page. The two-week and yearly calendar dates are color coded.

⇒ Weekend days without data entered are light yellow

⇒ Dates with data entered are light tan

⇒ Dates with the selected date are a darker brown

⇒ Any weekday without associated data will be white

Note you cannot enter data that is more than three months old.

Instructions:

Step 1

Navigate to and click product group selection.

Step 2

� Set the date.

Step 3

� Enter quantity available per ABO/Rh after cross-matches are released and before routine order received.



Step 4

� Either 'Submit' or 'Reset' the data.

'Submit' sends the data to AIM software and updates your day's record.

'Reset' will reset all the data fields to how they were when you first entered the page.

Step 5

� Enter any pertinent comments.

Step 6

� Enter 'Issuable Inventory' for all product groups.

The other fields included on the ‘Edit Daily Inventory’ screen are a combination of calculated fields and static data fields. A brief explanation of each will now follow.

Ideal Inventory

This is the hospital’s ‘Ideal Inventory’ level, as provided during the registration process in the 'Hospital Profile' document. This can be changed upon request.

One Day of Inventory

This is the average quantity of units the hospital’s primary blood center distributed to the hospital daily. This is calculated from the previous six months of blood center’s distributed product data. It is re-calculated for each month and approximates to one day worth of hospital inventory.

Days Worth of Inventory

This is another calculated field and is the result of dividing the issuable inventory by the 'One-Day of Inventory', e.g. 'Issuable Inventory' = 60, 'One Day of Inventory' = 20, 'Days worth of Inventory'= 60/20 = 3.0. 'Days Worth of Inventory' updates as soon as the 'Issuable Inventory' value is changed. If the value is >20, then a warning message is displayed. In the example quoted, the 'Issuable Inventory' would have to be greater than 400 to trigger this warning i.e. 401/20 = 20.05.

Blood Product Wastage Overview

The hospital transfusion service manually documents, overwrites, or views the electronically submitted wastage data using this function. If wastage is extracted and submitted electronically for the whole month's experiences, the last day of the month date will include all monthly wastages.



If daily files are submitted or manually entered, the day's date will contain the associated data. Blood product wastage experiences can be entered for all nine product group options.

The software offers nine wastage categories as well as the optional entry by fifteen different 'Service Lines'. If your hospital does not document wastage by 'Service Line', then leave the 'Service Line' selection at the default 'None Selected'. Once wastages are entered for a day with 'None Selected Service Lines', you may not enter wastages for a particular service line for that day.

Wastage Categories

The nine wastage categories are as follows:

� “IMPCM”: Improper Communication; Failure to inform laboratory of cancelled blood orders, patient demise, or improper ordering (e.g. wrong component requested).

� “IMPHA”: Improper Handling; Storage of blood units inappropriate (e.g. left at room temperature beyond allowable limits).

� “BKBIG”: Breakage/Bag Integrity; Blood unit integrity is lost due to improper spiking or bag leakage due to material failure.

� “PTNRD”: Patient Not Ready; Blood unit prepared and/or issued before the patient is ready for transfusion (e.g. IV line not available).

� “CANRX”: Cancelled Order: Blood unit obtained or prepared before order was cancelled. If cancelled before blood unit is obtained or prepared and lab not notified, document as IMPCM.

� “PTEXP”: Patient Expired: Patient expires after blood unit is prepared. If patient expires before blood preparation and lab not notified, document as IMPCM.

� “EQPFL”: Equipment Failure; failure of equipment used for storage, processing, or transport of blood products.

� “OUTD”: Outdated; product expired.

� “FVINP”: Failed visual inspection.

Service Line Categories

The fifteen available service lines are as follows:

� Bone Marrow Transplant Services

� Cardiology Services

� Emergency Services

� Hematology/Oncology Services

� Intensive Care Unit Services

� Medical Services

� Neonatal Services

� Nephrology Services

� Neurological Services

� Obstetric Services

� Orthopedic Services

� Radiology Services

� Solid Organ Transplant Services

� Surgical Services

� Blood Bank

Instructions:

Step 1

Navigate to and choose a product group.



Step 2

� Set the date

Step 3

� If 'Service Line' entry is not preferred, leave the default ‘None Selected.’

� Enter by wastage category.

Step 4

� Enter quantity of autologous wastages.

Step 5

� If the hospital prefers to enter your wastage experiences by 'Service Line', chose the applicable 'Service Line' from the drop down list.

Step 6

� If your facility did not experience any wastage for the month, document this by clicking ‘Zero Wastage’.

Step 7

� In the event you forget the meaning of the category, hover over the title for a pop-up definition.

The remaining blood product wastage fields are calculated fields. A brief description of each follows.

Service Line Monthly Totals

This is the total wastage for the current month for each blood group or autologous entry and by 'Service Line' (if a service line was chosen in the drop-down menu). The total for across all 'Service Lines' will not be available on this page. To determine total wastages across all 'Service Lines', a report of summary wastages can be generated from the ‘View Hospital Data’ icon.

Wastage as a Percentage of Net Units Distributed (WAPD)

WAPD is available for each blood group, service line and autologous entries. This calculation is available as a standardized approach to wastage calculation and reporting.

This calculation is derived from the quantity of blood products that are entered as wasted (numerator), divided by the total number of blood products of the same ABO/Rh and product group that were distributed to the hospital (denominator).



Allocated Inventory Overview

The hospital transfusion service manually documents, overwrites, or views the electronically submitted allocated (cross-matched) data using this function. On a daily basis, the hospital transfusion services either manually enter or electronically submit their inventory of red cells and leuko (reduced) red blood cells that are cross-matched and reserved for their patients. Data entry for this screen is the same as the ‘Edit Daily Inventory’ screen. The use of this function is to monitor the number of allocated units present on a daily basis.

Instructions:

Step 1


Step 2

� Set the date.

Step 3

� Enter the quantity of each ABO/Rh in the provided field and 'Submit'.

Inventory Transfers Overview

This page is for hospitals that send blood to other hospitals. This is a function that needs to be set up by your AIM team. If you would like to utilize this function of the software, please notify your blood center.

Note : This page should not be used for blood that is moved to another hospital knowing that it may be sent back by the receiving hospital if it is not used (cross-matched products).

You will be asked to complete 'AIM Request Update of Hospital Transfer List' by your blood center. This form provides documentation of the hospitals that you would like to be defined as recipient hospitals for your transferred products. Each hospital is asked to define a list of facilities to be added to their transfer recipient list. The form, once completed, should be sent to the AIM contact at your blood center.

Instructions:

Step 1

� Complete 'AIM Request Update of Hospital Transfer List'.

� Your blood center will notify you when your recipient hospitals are defined in the system.

Step 2




Step 3

� Set the date.

Step 4

� Enter quantity transferred per blood product group.

Transfused Data Entry Overview

The hospital transfusion service manually documents, overwrites, or views the electronically submitted transfusion data using this function. If transfusion data is extracted and submitted electronically for the whole months’ experiences, the last day of the month's date will include all monthly transfusions. If daily files are submitted or manually entered, the day's date will contain the associated data. Blood product transfusion experiences can be entered for all nine product groups that were previously listed on page 12 of this document.

This page is used to record the number of units that have been transfused to the hospital's patients.

Enter transfused products by:

� Product group,

� ABO/Rh,

� Service Line, and,

� Autologous product.

Instructions:

Step 1

Navigate to and choose a product group. Step 2

� Set the date

Note : Transfusions are entered either daily or monthly. In monthly entries, select the last day of the month for data entry.

Step 3

� If 'Service Line' entry is not preferred, leave the default ‘None Selected’.

� If 'Service Line' is preferred, choose as applicable, complete the quantity, and 'Submit' for each.

� Repeat for each product group.



View Hospital Graphs Overview

One of the major benefits from participating with AIM is the ability for hospitals to get their hands on a wealth of information in a variety of formats. This section will lead you through:

� Viewing basic charts

� Manipulating charts online

� Getting the chart data

� Copying and saving chart images

AIM allows hospitals the ability to choose which level of service is used to create the ‘Cluster’ or benchmarked hospital group. This allows comparison of your performance to hospitals providing a similar level of service. The hospital can filter the 'Cluster' by selecting one or more categories from their list of 'Available Categories'. The hospital can only select those categories to which they have been assigned, (e.g. those specified on the 'Hospital Profile' when registered). For a complete list of available categories, refer to the 'Hospital Profile' document.

All hospitals will have the following categories assigned:

� Annualized Platelet Usage

o Very High >401,

o High 201-400,

o Moderate 51-200,

o Low 11-50,

o Very Low 0-10

� Annualized Red Cell Usage

o Very High >4001,

o High 1601-4000,

o Moderate 801-1600,

o Low 251-800,

o Very Low 0-250

� Delivery Zone

o 1= 0-15 miles from supplier,

o 2=16-30 miles from supplier,

o 3=31-45 miles from supplier,



o 6= >120 miles from supplier

� Supplied by

o Blood Center

� Bed Size

o I is ≤100 patient beds available,

o II is >100 ≤300 patient beds available,

o III is >300 ≤ 500 patient beds available, or,

o IV is >500 patient beds available

These constitute the main filtering categories and will return a reasonable number of hospitals for benchmarking. Other categories are assigned where appropriate.



Note: Selecting multiple categories will restrict the number of hospitals within the benchmarking cluster further. If all categories are selected, the hospital may be benchmarking against only its hospital.

Within AIM, the number of hospitals that make up the comparative cluster is shown at the top of the 'Detailed Graphical Display' page. Note that the cluster count is the maximum number of hospitals with one data element available within any of the months making up the time period. This may not tally with the current profile value displayed in 'Edit Hospital Profile'. Each facility has 90 days to complete the data entry process, and therefore, the number of hospitals that have entered data will vary. Additionally, some data elements are provided by the blood center's data files.

The graph options are available for all product groups: Red Blood Cells, Leuko (reduced) Red Blood Cells, FFP, FFP >400mL, Cryoprecipitate, Pooled Cryoprecipitate, Whole Blood Platelets, Pooled Whole Blood Platelets, and Apheresis Platelets.

Instructions:

Step 1


� Your hospital name is displayed.

� List of graphs is displayed.

The date range can be set using drop down boxes.

� The first month you can select is the first month that you entered data.

� Available categories

Step 2

� Select the graph by clicking the radio button (clicking on the graph title also populates the radio button).

Step 3

� Select the date range. The date range chosen should be no earlier than the first date that you have entered data.



Step 4

� Select your category from the list of 'Available Categories'. Your 'Available Categories' are identified from the 'Hospital Profile' completed at the time of registration, and therefore affiliated with your hospital.

� To select a category, click on the text. To select more than one category, hold ‘Ctrl’ while you click on the category texts. To select a block of categories, highlight the first category, hold the shift key and highlight the last category in the list.

Step 5

� Once you have selected the required category(s), click the single right arrow to move them to the 'Selected Categories'.

� Use the double arrows to move all the contents of either the right box to the left box or vice versa.

Note : The 'Match' option allows you to find those hospitals with 'All Selected Categories' or 'Any Selected Categories'. In general, you will only want to select the 'All' option (default).

Note : If the user does not move a category into the 'Selected Categories' section and clicks on 'Submit', the system will aggregate all hospitals that are currently defined in the AIM software which have at least one data element within the time period chosen. If Internet Explorer is used, the pop-up box noted here is provided.



Step 6

� All charts will be displayed in this manner. They appear underneath the chart options in 2 columns. Scrolling down the screen will reveal more charts.

All charts contain data for the following information:

� Hospitals(in red)

� Cluster average (in blue)

� Standard deviation bar for the selected comparison (in green)

Step 7

� All the charts displayed in AIM are images. Therefore, you may easily copy it, save it or even set it as your wallpaper by right clicking any image (a list of options will be shown).

Detailed Graph Page

Step 8

� Click on the individual graph to take you to the 'Detailed Graphical Display' page.

� The 'Detailed Graph' page header describes the cluster count and your category(s) chosen.

� The chart image is shown in the middle. You can save or copy the image as described above.

� A legend showing the names of all the series on the chart is shown.



� The data that is used to populate the chart is displayed at the bottom of the graph screen. This information can be copied into a spreadsheet program, e.g. Excel, and used to draw your own chart.

Available Data Sets

Data Set and Examples Description

Wastage as a Percentage of Units Distributed to the Hospital (Bar)

� Sum of all wastage data entered in a month expressed as a percentage of the total units distributed in the same month, (e.g. the percentage of your monthly units distributed that were wasted).

� This is the only graph offered as a bar chart, which allows the extra dimension of wastage category to be shown graphically.

� The wastage bar chart shows the average for the selected hospital and the average for the cluster as separate bars (on the right). The standard deviation is not shown in this bar format.

� A graph for each blood group as well as combined 'A, B and O' and 'All Blood Groups' is displayed as thumbnails.

Wastage as a Percentage of Units Distributed to the Hospital (Line)

� Sum of all wastage data entered in a month expressed as a percentage of the total units distributed in the same month (e.g. the percentage of your monthly distributed units that were wasted).

� This option shows the data as a line chart showing total wastage (e.g. wastage for any reason). A graph for each blood group as well as combined 'A, B and O' and 'All Blood Groups' is displayed as thumbnails.

Percentage ABO of Total Received � Distributed units in a month expressed as a percentage of the total distributed in the same month. (e.g. the percentage of your monthly units distributed that were of a specific group or amalgam of groups).



Days Worth of Inventory � Average monthly inventory levels expressed as an index of how many 'Days Worth of Inventory' has been maintained at your hospital for that month.

� 'One-Day Worth of Inventory' is the average quantity distributed daily over the previous six months. (e.g. It approximates one day’s usage for your hospital).

� The 'Days Worth of Inventory' is how many days your available inventory would cover your transfusion needs based upon your historical usage.

Total Quantity Received � Total monthly gross number of units received at the hospital. (e.g. total units distributed from the blood center + transfers between hospitals.)

Inventory Age at Receipt � Percentage of units received from your blood center with the days since collection of each product.

� This is the age of the component at the time you received it at your facility.

Transfused as a Percentage of Units Received � Transfused as percentage of units distributed to your facility.

� Transfused+returns+transfers should equal 100% of units distributed to your facility.

� If percentage transfused is over 100%, then this indicates that more units have been transfused in any given month than inventory units received.



View Hospital Data The 'Charts' functionality of AIM allows hospitals to easily monitor their inventory, wastage, and transfused product levels; and to benchmark their hospital against definable hospital clusters (your peers). If you would like access to your raw data, (e.g. the actual values of your inventory, wastage, and transfused product levels on a daily basis), AIM allows you to do this via 'View Hospital Data'. Data from any table in the data section can be copied and then pasted into other software programs, (e.g. MS Excel). Added functionality in the 'View Data' section also allows you to easily edit the information currently held in AIM. Unlike the charts, you cannot 'View Data' for 'All Hospitals'.

Instructions:

Step 1


Step 2

� Select data set by clicking on text or radio button.

Step 3

� Select date range from drop down box.

Step 4

� Select view ‘Month' or 'Day’.

Depending on the data set, the 'Month' option will present either an average or a sum (inventory report averages your daily inventory).

� Name, detail level, and the calculation (average or sum), if any;

� Date field;

� Rows that are yellow have had a transfer, and;

� Total.

The example detail requested is for the monthly view.

If you wish to copy the data (press ctrl-c or select edit > copy), you can paste it into other software programs, e.g. MS Excel.



The Date Field

AIM provides the hospital with a functionality to view your data on a monthly or daily detail level (‘Wastage and Transfused’ data that is only entered on a monthly basis is an exception) . This allows you to view summaries of data over long periods. Simply select the required option in the detail box on the options screen. The summary calculation used depends on the dataset selected but is generally the sum (total) of all the daily data unless this doesn't make intuitive sense (e.g. monthly inventory, which is summarized as a daily average).

If you have selected the 'Month' as the detail level and you would like to drill down to see the daily data in a specified month, simply click on the month hyperlink.

Step 5

� Click on the month to review the report totals by day.

Step 6

� The table will be re-displayed showing the daily data for that month.

� Click on the day hyperlink in reports that are from data entry pages (e.g. inventory), you are taken to the data entry page for that date where you may edit your data.

Step 7

� This allows you the ability to edit your data entry pages from the ‘View Hospital Data’ functions.

Reports with Hyperlinks to Data Entry Pages

The reports within the ‘View Hospital Data’ function, which includes the hyperlinks that will take you to the data entry screens include:

� Inventory Level

� Wastage

� Transfers

� Transfused

� Allocated



Choosing the Data Set

For all the information you enter on AIM, there is a corresponding dataset; and you can also view your distributed data. In most cases, the data set will simply be displayed in a table similar to that described above but for some, there is extra information in the display. Below is a list of all the data sets, the extras, and a brief description.

� If a ‘Comment’ is available from the data entry page for that date, then a notepad icon will be displayed.

Data Set and Examples) Description

Inventory Level Monthly: Average monthly inventory data. When viewing monthly, click on the date hyperlink and this will take you to the daily view.

Daily: Daily inventory data.

The daily view shows the values that you have entered on AIM. If no data has been entered, then the date will be missing from the table.

If you click on the date in the daily view, it will take you to the edit daily inventory page for that date.

Wastage Monthly: Total monthly wastage data.

Viewing data on a daily view is not an option for wastage since data is entered monthly only.

On the monthly view, a ‘Total’ row is displayed for each month/date showing the ‘Total Wastage’ in that month/day. This row is highlighted in green.

Values in the table that are NOT zero are highlighted in grey.

Gross Units Distributed to the Hospital Monthly: Total quantity of units that were distributed per month.

Daily: Daily distributed data.

This table shows the total units distributed to the hospital from the blood center and makes NO adjustment for any transfers or returns.



Net Units Distributed to the Hospital Monthly: Total monthly net distributed data.

Daily: Daily net distributed data.

This table shows the total units distributed to the hospital from the blood center that is adjusted for any transfers that have been made to or from the hospital as well as units that were returned to the blood center.

On both the monthly and daily view, a row is highlighted in yellow if the values have been adjusted for transfers in that month/date. Only this row's date functions as a hyperlink and will transport you to the edit transfers page for that date. If transfers have been made TO the hospital, this page will not show any values. To see the transfers made TO your hospital, select the 'Transfers Between Hospitals' data set (see below).

Transfers between Hospitals Monthly: Total monthly transfers data.

Daily: Daily transfers data.

This table shows all the transfers TO and FROM the hospital. The direction of the transfer is identified in the 'Direction' field (sent or received). Only 'Sent' transfers have a hyperlink on the date field. The partner hospital is identified in the 'Hospital Name' field.

Transfused Monthly: Total monthly transfused data: This data set is available in the daily or monthly view based upon the hospital's provision of data daily or monthly.

The example shows monthly transfused data that has been entered by 'Service Line'. Therefore, multiple entries (up to fifteen) will be visible for each month.

Allocated Monthly: Monthly allocated data.

Daily: Daily allocated data.

The daily view shows the values that you have entered on AIM. If no data has been entered, then the date will be missing from the table. Allocated graphs are only available for red blood cell and leuko (reduced) red blood cell product groups.



Forms

Hospital Profile

Hospital Name

Ideal Inventory Levels

Ideal Inventory O Pos O Neg A Pos A Neg B Pos B Neg AB Pos AB Neg

Red Blood Cells

Leuko (reduced) Red Blood Cells

FFP

FFP >400mL

Cryoprecipitate

Pooled Cryo

Whole Blood Platelets

Whole Blood Platelets, Pooled

Apheresis Plts

Hospital Clinical Categories

This information will be entered onto AIM so that each hospital can compare data sets with hospitals having a similar profile.

Category Details Please √

Bed Size I ≤100 patient beds available

Bed Size II >100 ≤300 patient beds available

Bed Size III >300 ≤ 500 patient beds available

Bed Size IV >500 patient beds available

Trauma Services Level I or II

Trauma Services Level III or IV

Neonatal Intensive Care Level II or III

Children’s Hospital Specializes in pediatric services

Teaching Hospital Medical school is either attached or affiliated

Regional Hospital District or general facility

Private Hospital Independent facility

Veteran’s Administration Government funded healthcare provided

Cardiac Services Cardiothoracic surgical procedures provided

Hematology/Oncology Services Cancer patient care provided

Renal Services Dialysis provided

Neurological Services Neurological surgical procedures provided

Obstetric Services Women’s health services provided

Orthopedic Services Orthopedic surgery provided

Blood Conservation Program Facility has implemented a blood conservation program

Ambulatory/Day Surgery Provides outpatient surgery services



Electronic Cross-match Transfusion service uses electronic cross-matches

Intra/Post-Operative Cell Salvage Cell salvage utilized routinely

Transplant, Heart/Lung Facility provides heart/lung transplants

Transplant, Liver Facility provides liver transplants

Transplant, Bone Marrow Facility provides bone marrow transplants

Transplant, Pancreas Facility provides pancreas transplants

Burn Care Services Burn injury services provided

Supply Cross-matched Blood center provides blood that is cross-matched

Zone 1 0-15 miles from supplier (set by AIM)





Zone 6 >120 miles from supplier (set by AIM)

Annualized Platelet Usage (count random pools as dose equivalent)

Very High (>401), High (201-400), Moderate, (51-200) Low (11-50), Very Low (0-10)

Annualized Red Blood Cell Usage (count all red cell products)

Very High (>4001), High (1601-4000), Moderate (801-1600), Low (251-800), Very Low (0-250)



Please indicate needed addition or revision with a √ in box.

Contact Form: Hospital Information

Full Hospital Name:

Primary Blood Supplier:

New AIM User or Revise User

Name: Title:

E-mail:


Name:

Title:

E-mail:

Title:

Email E-mail:

Title:

E-mail:

Appropriate Inventory Management (AIM):

Contact Form: Hospital Information


Name:


Name:



Request Update of Hospital Transfer List

Contact Name: Contact Phone:

Full Hospital Name:

Job Title: Date:

Signature:

Primary Blood Supplier:

Full Hospital(s) Name:

Appropriate Inventory Management (AIM)

Request Update of Hospital Transfer List

I would like to add the following hospital(s) as recipient hospitals in my “Transfer” list:

Request From:



Hospital Automated Data Loads File Creation Checklist

A total of four files are needed to completely automate the hospital's data upload to the AIM software. The four data files referenced below have standard formatting to include: Extraction from your inventory system in ASCII mode, tab delimited, with or without column headers, no null values for any data row. The FTP account is 'write only'. Therefore, files should be placed onto the FTP account.


The blood center should work with your hospital clients to validate the information included in the following files as accurate and properly formatted prior to initial submission.

All files should be uploaded to the FTP account by 1:00 AM PST, 2:00 AM MT, 3:00 AM CST, and 4:00 AM EST.

Files needed include:

1._____File One: Issuable Inventory (needed daily ):

File Name: HospitalIssuableInventory.HospitalCode.MMDDYYYY.txt

Available inventory after cross matches release and prior to receipt of routine orders.

Technical Specifications :

FullFacilityCode: Varchar (20) HospitalCode from the Blood Center's Facility Identification Number (FIN).




2._____File Two: Allocated Inventory (needed daily ):

File Name: HospitalAllocatedInventory.HospitalCode.MMDDYYYY.txt

Red Blood Cells and Leuko (reduced) Red Blood Cells inventory that is cross matched.



ProductGroup: Varchar (2) – 1 = Red Blood Cells and 2 = Leuko (reduced) Red Blood Cells



3._____File Three: Wastages (needed either daily or monthly ):

File Name: HospitalWastage.HospitalCode.MMDDYYYY.txt

All wastage experiences collected by service line (cost center), product group, and ABO/Rh - If hospital provides on a daily basis, include day's date in file name. If hospital provides on a monthly basis, include the last day of the month for which data is included within the file name. Autologous wastage is collected in aggregate.







WastageCode: Char (5) -IMPCM: Improper Communication; Failure to inform laboratory of cancelled blood orders, patient demise, or improper ordering (e.g. wrong component requested); IMPHA: Improper Handling; Storage of blood units inappropriate (e.g. left at room temperature beyond allowable limits); BKBIG : Breakage/Bag Integrity; Blood unit integrity is lost due to improper spiking or bag leakage due to material failure; PTNRD: Patient Not Ready; Blood unit prepared and/or issued before the patient is ready for transfusion (e.g. IV line not available); CANRX: Cancelled Order: Blood unit obtained or prepared before order was cancelled. If cancelled before blood unit is obtained or prepared and lab not notified, document as IMPCM; PTEXP: Patient Expired: Patient expires after blood unit is prepared. If patient expires before blood preparation and lab not notified, document as IMPCM; EQPFL: Equipment Failure; failure of equipment used for storage, processing, or transport of blood products; OUTD: Outdated; product expired and; FVINP: Failed visual inspection.

BloodGroup: Varchar (6) (‘ O Pos’, ‘ O Neg’, ‘ A Pos’, ‘ A Neg’, ‘ B Pos’, ‘ B Neg’, ‘AB Pos’, ‘AB Neg’, 'Auto')


WastageDate: Char (8) MMDDYYYY

4._____File four Transfusions: (Needed either daily or monthly ):

File Name: HospitalTransfusions.HospitalCode.MMDDYYYY.txt

All transfusion experiences collected by service line (cost center), product group, and ABO/Rh- If hospital provides on a daily basis, include day's date in file name. If hospital provides on a monthly basis, include the last day of the month for which data is included within the file name. Autologous transfusions are collected in aggregate.







TransfusionDate: Char (8) MMDDYYYY



Glossary Allocated Blood products that are reserved or assigned for patient transfusion support

(e.g. cross-matched).

Cluster The aggregate of hospitals that are used for benchmarking against your data.

Days Worth of Inventory Available

AIM divides your facility’s ‘One Day of Inventory’ value into the quantity entered as 'Issuable Inventory' to determine how many days your inventory will last based upon six months of data.

Ideal Inventory Optimal quantity of blood products that your facility strives to maintain.

Inventory Age (Graph) This graphed report shows you the percentage of blood products that are received at your facility with their associated age from collection.

Inventory Transfers Blood products that are shipped from a transfusion service to another transfusion service.

Issuable Inventory The number of unreserved, undivided units available for cross-matching or allocating to your patients.

One Day of Inventory AIM averages the quantity of units distributed daily to determine 'One Day Worth of Inventory' for your facility.

Percentage ABO of Total Received (Graph)

This graphed report shows the percentage by ABO/Rh of blood products that are received at your facility.

Service Line Area of service within a hospital that provides a related level of patient care.

Transfused as a Percentage of Received (Graph)

This graphed report shows the percentage of each ABO/Rh that was transfused at your facility based upon the total number of units received.

Wastage as a Percentage of Distributed

This calculation is derived from the quantity of blood products entered as wasted, divided by the total number of blood products of the same ABO/Rh and product group that were distributed to your facility.

Appropriate Inventory Management Module Ithebloodconnection.org/.../AIM-Hospital-User-Guide.pdf ·...

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