The Gold Standard: Commemorating 50 Years
At one time, blood banking standards, in general, were considered little more than a “good idea,” just a few measures to make sure donors did not suffer from ailments such as “bizarre skin diseases” or rheumatic fever, and had not had any tooth extractions. Infectious disease screening was not nearly as extensive it is today; after all, bacteriologic cultures were only conducted every three months, screening just 1 percent of the blood collected that month, according to a historical vignette published in TRANSFUSION by AABB historian Paul Schmidt, MD.
Many years ago, the general consensus was that written and explicit standards were not necessary to guide practices in blood banking and transfusion medicine. “Back in the day there was more of a sense that ‘we don’t need to write it down … people know what to do,’” explained Frances Widman, MD, an AABB member since the mid-1960s.
In the early years of AABB, the focus was on technical methods rather than published, standardized processes and procedures. It was the Technical Manual — formerly titled Technical Methods and Procedures — that ultimately drove the development of standards, or, as Schmidt explained, “it was agreed that standards for ‘what to do’ were needed to supplement the Technical Manual’s guidelines for ‘how to do it.’” At that time, it was understood that standards would be necessary to carry out the wishes of the AABB Board of Directors to begin accrediting members by inspection. “They said, we can’t accredit people on the basis of the Technical Manual; we have to tell them what to do,” Schmidt said. “So they decided to write standards.”
Vintage Standards
According to Schmidt’s 1997 vignette, a document called the “Minimum Standards for Blood Transfusion” was developed in 1956 by an AABB committee aiming to reflect and promote ideal medical practice. A second draft, “Standards for Accreditation of a Blood Transfusion Service,” was prepared by the Joint Blood Council Inc. and circulated to the AABB Board of Directors for comment — the booklet was considered a preliminary product of both the Joint Blood Council and AABB and was only distributed in limited numbers for suggestions and corrections.
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