Role of the Transfusion Service Physician

According to the AABB Standards (Standard 1.0), the transfusion service (TS) must have a clearly defined structure and documentation of individuals responsible for key functions, including executive management. TS must have a medical director who is responsible for medical and technical policies, processes, and procedures. Hospital TS is typically within the departments of pathology and laboratory medicine (or clinical pathology).

Specific Roles

TS physician has multiple roles, responsibilities, and functions, including overseeing specific laboratories, laboratory and administrative policies and procedures, direct and indirect patient care, education, and research ( Fig. 20.1 ).

Transfusion Service

TS physician not only directs the TS, where pretransfusion testing and product modifications and dispensing occur, but also may direct other laboratories and/or clinical services, including human leukocyte antigen (HLA), cellular therapy, coagulation laboratories, and therapeutic apheresis, phlebotomy, infusion, collection, perioperative, patient blood management, and tissue banking services. Each of these requires policies, procedures, and medical, administrative, and technical oversight.

Transfusion Service Management

TS physician functions include strategic planning, project management, determination of scope and complexity of services offered, information technology oversight, clinical and technical consultation, utilization review, formation and promulgation of clinical guidelines, regulatory compliance, quality systems and assurance, quality control, human resources, and customer service.

Patient Care

TS physician can provide both direct and consultative patient care. Direct patient care, where services can be reimbursed through either Evaluation and Management (E&M) or Current Procedural Terminology (CPT) codes, is performed through therapeutic apheresis, therapeutic phlebotomy, and hematopoietic progenitor cell (HPC) collection, as well as interpretation of complex serologic and patient matching issues and evaluation of transfusion complications. Consultative services are often requested regarding provision of appropriate or specialized products, transfusion reactions, blood management, hemostasis and thrombosis-related test result interpretation, and apheresis. TS physicians improve patient care through policies and procedures that enhance quality, and through hospital committee participation (e.g., transfusion committee, patient safety committee).

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