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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).


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

September 18, 2014 11:59 AM by Eleanor Wolfram of The Power of Two

Every blue moon, when the money prize skyrockets, I purchase a lottery ticket. Generally, what drives me is the multi-million dollar money prize. However, just recently I learned that our gambling impulses may actually be driven by our genes.

Scientists uncovered that there are two major areas ...

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 ...

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 ...

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 ...

September 16, 2014 11:45 AM by Eleanor Wolfram of The Power of Two

What defines learning?  When does learning actually start? How does learning occur? Theses all question that regardless of your life science specialty, you have probably pondered.

Each of you probably has your own answer, but here's what several University of Arizona (UA) scientists think about the learning puzzle box.The UA team took a unique approach ...

September 12, 2014 9:51 AM by Eleanor Wolfram of The Power of Two

According to Wikipedia, "A cloaking device is a theoretical or fictional stealth technology that can cause objects, such as spaceships or individuals, to be partially or wholly invisible to parts of the electromagnetic (EM) spectrum."

Basically what this means in non-Einstein-physics jargon is light could be reflected and absorbed by the object causing ...

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


September 10, 2014 12:36 PM by David Plaut of David Plaut: Off the Cuff

I ran across an article recently that I thought you, like me, would find it interesting. The title of the article is "Effect of non-alcoholic beer on Subjective Sleep  in  university stressed population."

September 9, 2014 10:24 AM by Eleanor Wolfram of The Power of Two

A bully's mean attitude stomps into the china shop of a person's life like an ox. It does not matter what age you are, where you work, or live, bullies are everywhere. Now it seems that these relentless oppressors come in microscopic sizes too.

Just recently Netherland scientists have uncovered evidence that oxytocin hormone, a neurotransmitter, which is ...

September 8, 2014 6:00 AM by Scott Warner of Stepwise Success

As much as we would love to believe a job is just a job, it is much more than that: it consumes time, energy, and emotions; it advances, stalls, or kills careers; it creates fulfillment, ennui, or anger. And there's the other thing: coworkers. One blogger writes, "In business, it's not always about ...

September 3, 2014 6:06 AM by Scott Warner of Stepwise Success

I keep forgetting about the cool site Stumbleupon, which will find web sites based on your interests. Then I'll get an email, say "Aha!" and stumble away. I've found a few good ideas this way. For example, the other day I read an article on microsleep.

Microsleep, which is caused by sleep deprivation, is just what it sounds like: a short episode of sleep that lasts anywhere from a fraction of a second ...

August 29, 2014 1:53 PM by Michael Jones of ADVANCE Discourse: Lab


August 29, 2014 6:03 AM by Scott Warner of Stepwise Success

The more I hear about diabetes, the worse it sounds. The statistics on the disease, recently updated by the CDC, are alarming:

  • 29.1 million people have diabetes (9.3% of the US population)
  • 8.1 million people are undiagnosed (about 1 in three with the disease)
  • Based ...

August 27, 2014 12:55 PM by Irwin Rothenberg of CRI Lab Quality Advisor

We all want our employees to succeed; that is, do well in their job, and do their job well. This requires more that the didactic aspect of training, and goes beyond competency assessment. This requires the skill and intuitive ability of the manager to understand and apply what motivates their employees to do as well as possible, as well as moving beyond defining boundaries when staff  do not meet standards. ...


In the last blog we discussed a CDC survey addressing the difficulties ...

August 25, 2014 6:00 AM by Scott Warner of Stepwise Success

Scripting has been imposed on us, like many organizations, to standardize the customer experience. From answering the telephone to directing traffic, guidelines are set to make sure no matter who a patient or family member interacts with they receive similar treatment. This practice is so common in retail these days it's expected in many other settings.

Most often I've seen scripting developed by committees ...

August 22, 2014 12:54 PM by David Plaut of David Plaut: Off the Cuff

Laboratories have a major impact on patient safety: 80-90% of all the diagnoses are made on the basis of laboratory tests. Laboratory errors have a reported frequency of 0.012-0.6% of all test results.

Patient safety is a managerial issue which can be enhanced by implementing active system to identify and monitor quality failures. This can be facilitated by reactive method which includes incident reporting ...

August 20, 2014 6:04 AM by Scott Warner of Stepwise Success

"We never got the result!" is our most common complaint, followed closely by "My doctor never got the result!" It is frequently delivered in an accusatory tone instead of the more accurate "We can't find it. Did you send it?" Or even, "Did you perform the test?"

We hear the latter once in a while. We look up the patient who hasn't been seen in our hospital since 2008, and on the other end of the telephone ...


As anyone reads my writing knows I am a huge proponent of a more independent practice model for Medical Laboratory Scientists (and MLTs to a degree). A component of that model would be closer interaction with physicians and a willingness and ability to consult with physicians offering advice and information on medical laboratory testing.

August 15, 2014 6:01 AM by Scott Warner of Stepwise Success

Standard deviation index (SDI) measures bias using simple, easy to understand criteria. I also like this for daily quality control, because it works on all levels. Here's the calculation:

SDI = (Value - Target Mean) / Standard Deviation

Thus, a glucose of 97 with a control range of 80-100 has an SDI of 1.4. A positive SDI indicates a value above the mean; a negative value indicates a value ...

August 14, 2014 3:47 PM by Michael Jones of ADVANCE Discourse: Lab

Lately, I find myself becoming a little jealous of bears. That's right, bears - but not for the reasons you might think. Sure, it'd be great to hang out in creeks during the summer months, eating nothing but fresh salmon and berries all day, every day. I guess it'd also be pretty fantastic to be able to hibernate and sleep away the winter too, but ...



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.