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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).
December 19, 2014 6:04 AM by Scott Warner of Stepwise Success

One of our more common complaints is that we didn't do the correct test. We missed a test because it was not seen, illegible, or written on the back of a two-sided form; we assumed an abbreviation meant something unintended by the physician; we entered an order incorrectly into our information system. In very few cases do we forget to perform a test or perform it incorrectly. It's always GIGO: garbage in, garbage ...

December 17, 2014 9:52 AM by Irwin Rothenberg of CRI Lab Quality Advisor

One of the inevitable experiences of managing a workforce is dealing with difficult employees. In the broadest sense, we mean those who have demonstrated a lack of responsible behavior; but in a laboratory, where the continuum of work goes well beyond specimen testing (analytical) to include interaction and communication with the public (pre and post-analytical) ...

December 16, 2014 10:42 AM by David Plaut of David Plaut: Off the Cuff

Recently, in one of the blogs, I discussed NGAL. In that blog, I mentioned cystatin C (CC). It occurred to me that all laboratories do not offer CC. Here, adapted from the September, 2013 issue of Am. J. of Kidney Disease, is a series of questions and answers about cystatin.

What if my lab cannot measure cystatin C?
The 2012 KDIGO guidelines ...

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

Hematuria, or blood in the urine, is distinct from microhematuria. The latter isn't visible to the naked eye and is detected under the microscope. (The prefix micro is from the Greek mikros, meaning "small.")

It isn't unusual in urinalysis to see a clear urine with microscopic red cells. Microhematuria ...

December 11, 2014 5:23 PM by Michael Jones of ADVANCE Discourse: Lab

In the age of readily available genetic sequencing, the overabundance of data has been noted around the globe. As big data solutions become more common and diverse, the concept of data sharing has been a focal point of discussions regarding the future of research. A recent release from the National Institutes of Health (NIH) announced ...


Bigger is not always better, it turns out. It seems our appliances, gadgets and instruments are getting smaller; ...

December 10, 2014 6:07 AM by Scott Warner of Stepwise Success

It's becoming harder and harder to see what I used to take for granted. I've always been nearsighted and worn glasses since age ten. I've never thought twice about it until a few years ago. Myopia (nearsightedness) is caused by an image focusing in front of the retina because the eyeball is too long, the cornea or lens are too curved, or a combination of these factors.

December 9, 2014 10:45 AM by David Plaut of David Plaut: Off the Cuff

Recently, near my home in Texas, there was an Ebola scare when a case appeared quite unexpected until a little investigation discovered that the patient had been exposed on a recent trip. This suggested to me that a short blog on Ebola was in order. Ergo.

As of August 13, 2014, 2,127 patients across four West African countries have been infected with the ...

December 5, 2014 6:02 AM by Scott Warner of Stepwise Success

Asking for help can be difficult. We think of it as a sign of weakness, an act of capitulation, or a loss of political capital. But as Lorie Corcuera, co-founder and CEO of leadership firm SPARK Creations, writes in Inc., "The truth is, we never do anything on our own. And as leaders, we shouldn't ...

December 2, 2014 11:21 AM by David Plaut of David Plaut: Off the Cuff

Atypical squamous cells of undetermined significance (ASCUS) and low-grade squamous intra-epithelial lesions (LSIL) are minor lesions of the cervical epithelium detectable by cytological examination of cells collected from the surface of the cervix of a woman. Usually, women with ASCUS and LSIL do not have cervical (pre-) cancer. However, a substantial proportion of them do have underlying high-grade ...

December 1, 2014 11:51 AM by Irwin Rothenberg of CRI Lab Quality Advisor

One of the refrains I hear at every professional gathering is how so many of our issues would be resolved if we could just get the word out about our profession -- that is, if we could just educate other healthcare professionals about our work. If we could just educate the public about how important laboratory testing is; that our work is the basis for 70 percent of all physician medical decisions; ...

December 1, 2014 6:05 AM by Scott Warner of Stepwise Success

What we do is often complicated. For example, asking for help from coworkers sounds easy but isn't. Clinical psychologist Ellen Hendrickson cites several reasons we don't including fear of being a burden, fear of losing control, fear of owing a favor, fear of appearing weak, and fear of rejection. ...

November 26, 2014 6:15 AM by Scott Warner of Stepwise Success

As the holidays approach I'm reminded how families get along (or don't). Our work families are no different. Coworkers with different styles and priorities forced to work together can test patience and professionalism. So long as the work gets out accurately and timely, the ends may justify the means, but we've all worked with a tech (or are one!) whose work habits grate nerves.

Here are a few morphotypes:

  • The ...


In a few days the country will be celebrating Thanksgiving,but this festive holiday means different things to different people. To many it will be a day off from work, a time to spend with family, to over-eat and drink too much. It will be a time when family members get to show off their favorite recipes, critically assess relatives they haven't seen all year and, if lucky, enjoy a long weekend. ...

November 24, 2014 11:17 AM by David Plaut of David Plaut: Off the Cuff

During the past few years a number of investigations of NGAL have demonstrated that this marker is a "useful biomarker in clinical nephrology which is helpful to diagnosis and evaluate the categories for CKD proposed by the KDIGO." In a recent study Xiang et al found that the concentration of the NGAL increased progressively with the increasing of risk categories (proposed by the revised CKD classification). ...

November 21, 2014 6:07 AM by Scott Warner of Stepwise Success

Every meeting takes at least an hour, not including prep, finish, and homework time. Many meetings run over. They are, as Charlie Kim describes in the Huffington Post, red wine discussions (might as well drink, because nothing will be accomplished) or lectures (why attend at all?).

I've ...

November 20, 2014 11:12 PM by Eleanor Wolfram of The Power of Two

The sport of boxing teaches people to be strong physically and mentally. Boxing teaches the skill of how to take a punch and not turn to run away when you see the menacing glove approaching your bare face. This sport reinforces the underline meaning of the physiological hormonal "fight or flight" response.

Well ...

November 18, 2014 1:08 PM by Eleanor Wolfram of The Power of Two

When a sports team has possession of the football, it can score points in several ways, such as field goals and touchdowns. It seems that a group of international scientists has just recently uncovered a genetic mechanism that controls the Streptococcus pneumonia, which causes infections which could lead to death

The bacterium pathogen Pneumococcal can be ...

November 17, 2014 6:03 AM by Scott Warner of Stepwise Success

One size fits all is an advertising gimmick, but we all know it isn't true. Shelves are too high, microscopes are too low, and there is never enough room for paper. But the reality of our workspace is that it has to be designed to fit most people. This can be difficult in today's laboratories.

For example, according ...



Just a few short weeks ago, Ebola was the talk of the town. Both the lay public and healthcare professionals seemed consumed with the topic. Entire cottage industries were born to supply Ebola-proof personal protective equipment (PPE) and ...

November 13, 2014 11:46 PM by Eleanor Wolfram of The Power of Two

Antifreeze has worn many faces, both positive and negative. On the positive side, it is used across the globe as a liquid used to cool engines. However there has been occasion where this chemical was viewed from the negative of poisoning.

For example, my first acquaintance with the negative side ...

November 13, 2014 11:51 AM by Irwin Rothenberg of CRI Lab Quality Advisor

In the previous blog, we discussed the factors that make one shift different from another, and how an awareness of these differences is important for the proper management of the workload and staffing for these shifts.  Since each shift is part of the continuum of the lab operation for that day, when chronic problems are happening on a particular shift, it is important to determine if the ...

November 12, 2014 6:44 AM by Scott Warner of Stepwise Success

Our tendency to comment results with disclaimers is strong. Examples:

  • Reporting pathogens in a urine culture with many skin flora and adding "possible contamination"
  • Reporting a potassium on a hemolyzed sample and adding "hemolysis may increase results"
  • Reporting a WBC differential and adding "fibrin strands seen on peripheral smear"

There are a few schools of ...


My dad was so proud of the fact that he worked for the same employer for 40+ years. He was never late, was rarely sick and sometimes went to work despite the fact he was under the weather. He thought he was indispensable and that his employer ...

November 7, 2014 6:01 AM by Scott Warner of Stepwise Success

Do you remember other kids eating dirt when you were young? It was commonplace to make mud pies, jump in puddles, and put tadpoles in pockets. We all played outside in dirt and grime, bit fingernails, ate baloney and cheese sandwiches without hand washing, drank from the garden hose, and played on the floor in retail stores. It never occurred to any of us that we could get sick, and if we'd been told we all would ...



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.