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Stepwise Success

Sensitivity and Specificity
October 2, 2015 7:08 AM by Scott Warner
I hope I’m not the only one who gets confused about sensitivity and specificity. Every now and then I have to rethink this. Sensitivity defines the true positive rate, or the number of people correctly identified as having a disease. A highly sensitive Read More...
Arbitrary Rules
August 7, 2015 6:44 AM by Scott Warner
Since the laboratory is a mystery to many in your organization, it’s a good idea to use any arbitrary rules as teachable moments. You might be surprised how many of these exist. Specimen labeling rules Specimen rejection rules Wristband protocols Compatible Read More...
Faster Troponins
July 24, 2015 6:16 AM by Scott Warner
At a meeting our QI director at that time pulled out a folder and told me, “These are your troponin turnaround times.” It showed hardly any times under 60 minutes, an industry consensus. Most of the times were over 90 minutes. When I returned to the laboratory Read More...
Catalase Oddities
July 6, 2015 6:34 AM by Scott Warner
Catalase is an enzyme present in many living cells responsible for breaking down hydrogen peroxide (H 2 O 2 ) into water (H 2 O) and oxygen (O 2 ). It prevents peroxide, a byproduct of many reactions, from damaging cells. Catalase is also used in food Read More...
Correcting Corrective Action
May 18, 2015 6:03 AM by Scott Warner
Lab techs typically think of “corrective action” as it relates to quality control. A QC point is out, the tech checks reagent levels, finds out the reagent level in the well is low, puts on fresh reagent, and repeats the controls. But was this really Read More...
Micro Around the Clock
April 20, 2015 7:13 AM by Scott Warner
“Use it or lose it” is true in exercise, neuroscience, and our work lives. If a small laboratory doesn’t use its micro department to its fullest, it could lose it. In my last blog I described how cultures are processed for the convenience of the laboratory, Read More...
When Do You Do Micro?
April 15, 2015 8:19 AM by Scott Warner
If your small laboratory still performs microbiology testing in house, competency and competition present stiff challenges. If only a few people on your staff do micro identification and susceptibility testing, that leaves a staffing gap you’re forced Read More...
Math is Hard at 3 AM
April 6, 2015 6:04 AM by Scott Warner
I became comfortable working up body fluids when I worked in a hospital with two pediatricians and several orthopedists on the medical staff. Every few days (it seemed) we received a septic joint fluid, synovial fluid for crystal analysis, or a septic Read More...
Economies of Scale
March 27, 2015 6:39 AM by Scott Warner
Are we seeing the last gasps of community hospital laboratories? Sometimes I wonder. A 2007 article in Clinical Chemistry states , “Many laboratories already outsource esoteric tests to other (reference) laboratories, but outsourcing should also be considered Read More...
Populations and Pathogens
March 18, 2015 6:01 AM by Scott Warner
The American Academy of Microbiology website states , “The human microbiome, the collection of trillions of microbes living in and on the human body, is not random, and scientists believe that it plays a role in many basic life processes.” Our gut flora Read More...
RSV Season
March 13, 2015 6:06 AM by Scott Warner
There’s been a lot of paranoia about influenza, much of it justified. The 1918 pandemic killed as many as 30-50 million people worldwide, and 675,000 in the US. We don’t know for sure. But in an average non-pandemic year influenza kills between 3-49 thousand Read More...
When Should You Upgrade?
March 9, 2015 2:13 PM by Scott Warner
Your laboratory is probably a mix of old and new technology. You may have refrigerators decades old, small centrifuges that were purchased used and still run strong, a coagulation analyzer at the end of its five year contract, and a chemistry analyzer Read More...
Thinking About Rainbows
February 18, 2015 9:40 AM by Scott Warner
Hospital acquired anemia can be an issue if multiple tubes are collected several times a day. Over time, small amounts of blood (5 mL is a teaspoon) add up. I’ve developed a “short draw” protocol to use low volume tubes and chart the amount drawn for Read More...
Do You Look At Charts?
February 4, 2015 5:45 AM by Scott Warner
When I blogged about looking at inpatient charts in 2012, we had implemented CPOE (Computerized Physician Order Entry) to a limited degree. Now that it’s commonplace and there are few written physician orders, it’s still useful to look at charts. Each Read More...
The Old and the New
January 12, 2015 6:03 AM by Scott Warner
Many years ago when I was taught to run a Monospot, I was instructed in the fine art of rotating the card in a figure 8. The goal was to equally rotate the mixtures in all circles while scanning for agglutination. But in case that was too difficult, vendors Read More...


About this Blog

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