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Stepwise Success

Speak For Yourself

Published January 6, 2010 6:14 AM by Scott Warner

Industrialist Henry Kaiser (think steel, aluminum, and Permanente) said, "When your work speaks for itself, don't interrupt." While our work speaks for us, others see us as test menus and reports with – perhaps – a vague notion of instruments, microscopes, and acronyms from watching House. Or – worse – our expertise is extrapolated from an inadequate understanding of "simple" point of care tests.

Others interrupt plenty: nurses and doctors complaining about turnaround time, "unbelievable" results, availability of blood for transfusion, "unreasonable" sample requirements, et al. Some days, we're lucky to get a word in.

One example: I returned on Monday to an INR complaint from a physician. From the weekend tech's notes I gathered that the specimen was collected at a physician office early on Friday, dropped off at the laboratory in the afternoon, and the doc was called that evening with the result at her request. Ordered routine and not critical, her complaint was obscure. But my email had the answer from the office nurse: our laboratory was too slow. We waited too long to run the test, we should have called the result sooner, and the tech who ran the test needed discipline. All that from reading a report!

I telephoned the ordering doc, who said, "When the lab called me with the result I didn't have a current patient phone number and couldn't reach him to adjust his meds. Can you fix that for me?"

Sure enough, the office had omitted patient contact information on the requisition. I telephoned the office nurse and suggested they write current patient contact information on requisitions. She promised to do so, and I made sure our techs knew about the problem.

There was no mea culpa on her end. It doesn't matter; there was a crucial conversation with the ordering physician and a system change. Unfortunately, these kinds of incidents are all too common. Too bad we can't always interrupt.

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About this Blog


    Scott Warner, MLT(ASCP)
    Occupation: Laboratory Manager
    Setting: Critical Access Hospital
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