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ADVANCE for Laboratory is thrilled to welcome you to DeLABerations: A Medium for Lab Professionals and Managers, part of the Healthcare POV: Blog and Forum Community from ADVANCE. Our blogs tackle timely questions, offer advice and opinions about the laboratory field and connect professionals nationwide. We have provided tags to assist in locating topics of interest, a profile page to make uniquely your own and a list of our most active posts to keep you abreast of the latest discussions. We look forward to hearing more about your field from your Point of View (POV).
LATEST POSTS FROM EACH BLOG
October 16, 2014 4:25 AM by Eleanor Wolfram of The Power of Two

Today a gray hair sprang up when I started rinsing out the shampoo from my morning shower. Not so happy about gray hairs, but I am happy to report no wrinkles -- or, better yet, no crow's feet. For those not familiar with signs of aging, crow's feet otherwise known as "laugh lines" are those lines that radiate from the eyes. Once you start getting crow's feet, even makeup won't help hide them


 
October 15, 2014 10:45 AM by Lynn Nace of ADVANCE Discourse: Lab

All of the phlebotomists are probably cringing at the term I used in the headline, but it seems germane considering the overwhelming number of comments the ADVANCE editorial staff has received since the launch of our 2014 Salary ...


4 comments  
October 15, 2014 10:40 AM by David Plaut of David Plaut: Off the Cuff

Upon emerging from the thymus, naive T cells circulate in the blood through lymph nodes and seek foreign ("nonself") antigens. T cells can recognize not only pathogen-associated antigens, but also abnormally expressed self-proteins-indicating mutated or transformed tumorigenic cells -- as "nonself." If T cells encounter their specific antigen in the context of appropriate co-stimulatory molecules, ...


 
October 15, 2014 6:03 AM by Scott Warner of Stepwise Success

The late oil well firefighter Red Adair said, "If you think it's expensive to hire a professional to do the job, wait until you hire an amateur." During staffing shortages or budget crunches it can be expedient to hire a warm body but disastrous in the long run. Amateurs often don't know what they don't know, think they know more than they do, and lack an ability to self-correct behavior that all professionals possess. ...


 
October 14, 2014 10:39 AM by Eleanor Wolfram of The Power of Two

Candida is a common source of hospital-acquired infections, a fungus that affects the blood stream, and is occurring more frequently to become the fourth most common pathogen found in blood cultures in the U.S.

The infections resulting from Candida can lead to sepsis, a dangerous life-threatening complication where inflammation throughout the body can damage ...


 

Just a few short months ago Ebola was a disease in a far away continent. The greatest fear was that with our internationally mobile population a case or two might slip into the USA. Then 2 Americans in Liberia contracted the disease and were flown back amongst great fanfare to Atlanta's Emory Hospital where they ...


4 comments  
October 10, 2014 6:15 AM by Scott Warner of Stepwise Success

Our current hematology analyzer was a big step up from a Sysmex K4500 with a 3-part differential to a Sysmex XT-1800i with a 5-part differential. I remember arranging a conference call between the bean counters and the pathologist to explain why the difference was important. Since then we have successfully eliminated percentage differential reporting, bands on scans, and reduced manual differentials to one or two ...


 
October 9, 2014 3:37 AM by Eleanor Wolfram of The Power of Two

The growth of sports lab testing on illicit drug use and abuse is on the rise due to the seriousness of blood boosting. Yearly, over 100,000 sports drug tests are conducted worldwide at a cost of $30 million. The hope is that the lab tests detect and deter drug abuse among competitors.

With so much money on the line for both individual athletes and their ...


 
October 8, 2014 1:31 PM by David Plaut of David Plaut: Off the Cuff

In mid-2013, William Kuhens was diagnosed with myelogenous leukemia (AML). The only treatment for him was experimental. He was assigned in a Phase 1 trial with little hope -- for these studies are usually used only to investigate what dose could be handled and what the side effects were, not to send the cancer into remission. There were 10 patients in this trial of a new drug, AG-221, which ...


 

Why do we run quality control in the laboratory? The simple, obvious answer is to ensure that the entire test system working together is able to produce reliable results. The rub lies in the concept of reliability. So we run QC based on manufacturer's directives. But how does the manufacturer ...


2 comments  
October 6, 2014 6:00 AM by Scott Warner of Stepwise Success

A hospital's culture defines how it responds to customers and crises, whereas a cult is defined by the dictionary as "a group or sect bound together by veneration of the same thing, person, ideal, etc." Cults have ideology, rituals, and symbols. Most hospitals have a cult of busy.

  • Ideology - the belief that "busy" means ...

 
October 2, 2014 5:16 PM by Irwin Rothenberg of CRI Lab Quality Advisor

The laboratory profession is changing so quickly that sometimes it is hard to keep up. Not only are we impacted technologically with new tests, new modes of communication and new venues for storing and retrieving data, but we are seeing innovative use of advanced technologies for our routine testing (hello, LC/MS?). In addition, our whole regulatory environment is changing just as fast. Add ...


 
October 1, 2014 4:26 PM by Michael Jones of ADVANCE Discourse: Lab

Ebola is a subject that's been on everyone's minds for weeks and, as such, has received a lot of media attention. I've covered the Zaire Ebolavirus before and even discussed the heroism of those responsible ...


 
October 1, 2014 6:00 AM by Scott Warner of Stepwise Success

In 2011 I blogged about using a binary search algorithm to find a point of failure when performing a sample lookback with a large number of samples. In dealing with sample lookback and revising our own policies since then, we've hit a few snags:

  • How should we account for other instrument ...

 
September 30, 2014 9:59 AM by David Plaut of David Plaut: Off the Cuff

There was a point-counterpoint "debate" in a recent issue of Clinical Lab News. Arguing for reporting A1c as SI was Ian Young from Ireland; for keeping A1c as percentage -- at least in the United States -- was David Sacks from the NIH in Bethesda, MD.

Young posited that the use of percent gave values that were quite similar to the SI units (mmol/L) for ...


 
September 26, 2014 6:00 AM by Scott Warner of Stepwise Success

In my last blog I said computers are stupidly reliable. They do whatever they are told, over and over. And they don't get bored or make mistakes. It's easy, for example, to create little programs that send keystrokes to applications. I use a freeware ...


 
September 24, 2014 10:28 AM by David Plaut of David Plaut: Off the Cuff

We all know that hemoglobin A1c (A1c) is a good marker for the amount of glucose in the blood stream and that a level of 6.0 percent is considered "normal." As Oscar Wilde had one of his characters in the Importance of Being Earnest say, "Life is rarely pure and never simple." I am sure we would all agree with this. There was an article in the July issue of the Mayo Clinic Proceedings that ...


 
September 22, 2014 6:00 AM by Scott Warner of Stepwise Success

Back in the day we imagined computers were smart. In a 1964 Twilight Zone episode called "The Brain Center at Whipples," a CEO who heartlessly replaces workers with robots is himself replaced by Robby The Robot from the 1956 classic Forbidden Planet. Capek to H.A.L. to Nomad to Tron's Master Control -- science ...


1 comments  

 

The concept of Pay for performance (P4P) is based on the use of incentives to encourage and reinforce the delivery of evidence-based ...


1 comments  
September 17, 2014 10:25 AM by Irwin Rothenberg of CRI Lab Quality Advisor

I have never seen a well-run laboratory, providing quality patient service, that did not have complete up-to-date and well-organized procedure manuals. But the implication of "procedure manual" as a descriptive term is really incomplete. It is more than just the step-by-step directions for performing a test. If that was all we needed, then the manufacturer's insert would be far more ...


2 comments  
September 17, 2014 10:22 AM by David Plaut of David Plaut: Off the Cuff

In 1974, the College of American Pathologists (CAP) proposed an algorithm for accepting/rejecting analytical runs using 2 controls. The algorithm used 3 rules to reject a run - 1 3SD,* 2 2SDw and 2 2SDa. In 1981, Westgard et al. (JOW) proposed an expanded set of rules. Both groups were clear on the idea that a single value beyond the 2 SD limits was not a reject signal.

In ...


2 comments  
September 17, 2014 6:03 AM by Scott Warner of Stepwise Success

I hate tape. I don't really mind having blood drawn, but tape is a pain. Yanking or coaxing it off, it doesn't matter. Getting hair ripped off my arms always hurts more than a needle.

So when the phlebotomist or medical assistant says, "Hold this for five minutes," I happily comply. And if they go for the tape, I insist on holding the gauze over the wound. It will stop quickly enough.

One ...


3 comments  
September 12, 2014 6:00 AM by Scott Warner of Stepwise Success

Middle managers are often told to "engage" employees with buzzwords and gimmicks: empowerment, inclusion, work teams with stupid names made of acronyms, action plans, team huddles, and good old-fashioned delegation. We need to train our replacements, mentor those with potential, tell stories, emphasize cultural values, give feedback, hold people accountable, and manage by walking around. And we should have an open ...


 
September 11, 2014 9:40 AM by Michael Jones of ADVANCE Discourse: Lab

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ABOUT OUR BLOGS

Glen McDaniel, MS, MBA, MT, CLS will encourage dialogue among clinical laboratorians, with the ultimate goal of not simply to commiserate, but to empower readers into full, rewarding practice; not simply to survive, but to thrive.

David Plaut, a chemist and statistician in Plano, TX, provides his unique perspective on hot topics within the clinical lab industry.

Join Scott Warner, MLT(ASCP), in exploring and sharing solutions. Scott's goal is to not just save time and effort but to also develop a team that discovers its own laboratory success.

The ADVANCE for Administrators of the Laboratory editorial staff will offer personal perspectives on issues in the clinical laboratory field and current healthcare environment.

The Politics of Healthcare covers the latest developments in healthcare policy and legislation.

This staff blog focuses on good news and exciting events throughout the lab industry.

COLA experts share their field experiences, insights and suggested resources to assist laboratories achieve a culture of quality patient care.

Eleanor Wolfram, MS, uncovers the benefits and mishaps that occur when the field of clinical laboratory science is combined with other industries, such as engineering, manufacturing or technology.