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Stepwise Success

The Joys of Shopping
July 29, 2016 6:09 AM by Scott Warner
Change is constant, especially in laboratory medicine. Monoclonal antibody assays changed latex agglutination kits; discrete random-assay analyzers changed batch testing; point of care instruments are refocusing core laboratory testing. These days, leaving Read More...
Do Doctors Read Comments?
June 18, 2016 6:40 AM by Scott Warner
Laboratories add comments to reports, some of which are informative e.g. CRITICAL VALUE REPEATED and others that are interpretive e.g. explaining the meaning and utility of the MDRD estimated GFR equation. It is the latter that brought me to this current Read More...
Slide Review or Manual Diff?
May 18, 2016 5:59 AM by Scott Warner
The CPT code 85004 (Blood count; automated differential WBC count) has many variations, each of which is charged instead of 85004 and including the work. These codes can be distinguished in the CPT code book, because they are indented. Examples: 85007 Read More...
Is PCR Ready for Small Labs?
May 2, 2016 6:36 AM by Scott Warner
What is true for big labs eventually becomes true for small labs, mostly because volume discounts drive affordability. This is most recently true for PCR, a technology that has arrived in small laboratories for two platforms, the Meridian Illumigene and Read More...
Limit Input
April 13, 2016 4:59 PM by Scott Warner
One of the oft-quoted nuggets in The Elements of Style is “omit needless words.” I’ve seen this rule praised and criticized with equal fervor. As a writer, pruning and trimming prose seems like a necessary path to clarity for the reader. It is also intensely Read More...
Simplify Urinalysis
March 25, 2016 6:40 AM by Scott Warner
Urinalysis is one of the simpler screening tests laboratories perform. Modern dipstick readers have standardized and simplified the chemical analysis of urine. But what about the microscopic? Shouldn’t that also be simplified? Beckman Coulter and Sysmex Read More...
Know What Docs Want
February 26, 2016 11:48 AM by Scott Warner
A lab tech’s job is very linear. Requisitions arrive, specimens are collected that match the tests that are checked off, the work is done, the tests are reported. We know what docs want. Right? For the most part, yes. Most docs - especially younger ones Read More...
The Rh Conundrum
December 11, 2015 6:01 AM by Scott Warner
The conundrum of Rh confounds many a blood banker. Since its discovery nearly 80 years ago, our understanding and treatment of Rh types have evolved. Here are a few common problems that I encounter: Weak D. A weak D recipient is considered Rh Neg. A recipient Read More...
Do You Still Use a STAT List?
November 27, 2015 12:45 PM by Scott Warner
A STAT list is a relic of a time when it was common for labs to have call, labor intensive tests, and batch testing. If your lab has any of these, you may also have a STAT list. It’s a list of tests that your lab performs STAT, and anything not on the Read More...
Old Methods
November 23, 2015 6:04 AM by Scott Warner
How many old methods are being performed in your laboratory? Old technology gives way to new at varying rates. Examples of “old” technology include Westergren sedimentation rate, Miller disc reticulocyte estimates, and bleeding times. These and others Read More...
Make or Buy?
November 4, 2015 6:00 AM by Scott Warner
The website Investopedia defines “Make-or-Buy Decision” as “The act of choosing between manufacturing a product in-house or purchasing it from an external supplier. In a make-or-buy decision, the two most important factors to consider are cost as availability Read More...
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...


About this Blog

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