Stepwise Success

Move Smarter

2013-05-15T09:59:00Z

Repetitive motion injuries are commonly caused by cumulative trauma to musculoskeletal joints such as thumbs, elbows, and shoulders. These have always been common in workplaces but there is greater awareness during these long days of people sitting at computer terminals. Hours of restrictive movement using the same muscles that involve fine motor control e.g. mouse clicking and keyboard typing can cause injury. WebMD points out problems related to ergonomic issues, including: Bursitis - the bursa...(read more)

Ergonomics and Exhaustion

2013-05-10T10:25:00Z

When we renovated our lab design, moving walls, equipment, and refrigerators, one of the techs joked the newly opened space made it “walker ready.” “We aren’t getting any younger,” she said. That seems to be a theme these days. I’m not sure we’ll be working with walkers -- I hope not -- but ergonomics and exhaustion seem to bedevil us at every turn. The Occupational Safety and Health Administration (OSHA) has this to say about ergonomics: “Ergonomics is the science of fitting workplace conditions...(read more)

Ageism in the Laboratory

2013-05-06T09:57:00Z

Pardon the pun, but it’s an old story. According to the Hospital Council of Northern & Central California, “The average age of a CLS in California is above 50. There are not enough new CLSs in the pipeline to equal the numbers currently working but planning to retire,” which says it all. We are all getting older. Our laboratory has a pretty good cross-section of laboratory ages: most of us are in our mid-fifties, a handful are in their mid-forties, one or two are in their mid-thirties. We are...(read more)

We All Want Simple Solutions

2013-05-01T10:24:00Z

It’s easy to make solutions more complicated. When there are holes in a schedule, one can create multiple rotation lists with conditional rules. When quality control is out, one can apply more Westgard rules than are needed. And when microscopic cellular elements are evaluated, one can apply criteria that are too detailed to be practical. Laboratory professionals are a pragmatic and dogmatic lot, generally, trained to follow stepwise instructions. Many times I’ve heard, “I don’t run that test very...(read more)

Corrective Action

2013-04-26T10:02:00Z

Corrective action is a beautiful thing. When quality control is out of limits, running a fresh control that is acceptable saves time, avoids an irritating sample look back, and reassures the tech. When a weak blood bank reaction in all tubes disappears by recollecting a sample and letting it clot in the refrigerator, a simple fix is found. And when an instrument problem is identified and repaired before a service call, everyone is happy. Corrective action should always be this easy, but I’ve seen...(read more)

Reproducible Cutoffs

2013-04-22T11:25:00Z

A million monkeys on a million microscopes probably couldn’t bang out an accurate WBC differential in a million years, but a lab tech could teach a gibbon to run a chemistry analyzer in about ten minutes. I’m kidding. But the subjective variability of microscopic analysis versus objective reliability of engineered automation is known. WBC differential, abnormal cell identification, manual cell count, cell count estimate, crystal analysis, urinalysis, or Gram stain often have significant variation....(read more)

Improve Your Criteria

2013-04-17T10:04:00Z

An acronym pulled from the alphabet soup is CQI, or Continuous Quality Improvement. Managers and quality improvement people use this to show that everything can be improved, even processes that work. Continuously trying to improve quality generates incremental improvements; rather than completely redesigning a process, it is changed in response to data collected, often in a PDCA (Plan-Do-Check-Act) cycle. A good example of where this idea can be applied is your criteria to review blood smears in...(read more)

Why Fasting?

2013-04-12T09:58:00Z

Each day, I see people arrive for work after they have had breakfast at home. They sometimes arrive with coffee. Within two hours or so they go to morning break and eat a muffin, fruit, or some other snack, often with more coffee. Two hours later they have lunch, and so on. Our days are one long glucose tolerance test. Yet we require that patients fast eight to fourteen hours before measuring substances commonly found in all these foods and drinks. The Quest website puts the reasoning succinctly:...(read more)

Keeping Benchwork Exciting

2013-04-08T10:02:00Z

The other day after I explained a change in microbiology an employee told me, “That’s three times you’ve used the word ‘exciting.’ That’s not a word I would use.” This was said in good humor, but the point is valid. Slogging out results day in and day out, thousands a year, can be tedious. How do we keep benchwork exciting? While the question is closely related to motivation, camaraderie, culture, and other workplace conditions, it’s much simpler. It boils down to what keeps the hands on work of...(read more)

Your Work, Your Family

2013-04-03T10:11:00Z

Stress is big trouble in all our lives. It seems to me that we can handle stress at work or home but not both. Life being what it is, stress seems to jump from one to the other and seldom sits still. At home, family can help us cope with stress. Does a work family do the same thing? Many employees have told me, “We’re like family here. We help each other all the time.” This makes sense, if we admit to not being able to hide ourselves for very long. Not many of us can completely hide emotional pain,...(read more)

Is Scripting Bad?

2013-03-29T10:03:00Z

We encounter scripting all the time. When calling customer service, at the end of the call, the representative says, “Have I answered all your questions today?” In a restaurant, a waiter will say, “My name is Matt, and I’ll be your server.” And at the supermarket the checkout person will ask, “Did you find everything you were looking for today?” While some of this sounds robotic, it all does what is intended: build an expectation in the mind of the customer of what happens next, no matter the employee....(read more)

Can You Read Expiration Dates?

2013-03-25T10:02:00Z

A common task we are expected to perform is checking expiration dates on reagents, controls, and other dated materials. Boxes are crowded with different languages, vials are smaller, and eyesight fades with age. I remember vividly the moment when I couldn’t immediately adjust between a crossword puzzle and the wall clock. What if we miss a date? Suppose, for example, a vial of blood bank reagent has expired a few days and the techs just misread the date, the date was covered by a received sticker,...(read more)

Self Control

2013-03-20T10:00:00Z

We all have moments when we lose self control, usually under stress of some kind: frustrated by highway traffic, pressed for time, shopping in a crowded store, irritated by arguing. In a similar way, stress in the laboratory can cause us to lose self control of a different kind: our own personal checks and balances in performing manual testing. Engineers rely on different kinds of feedback loops to ensure a system is properly maintained. In a feedback loop, actual output is compared to desired output...(read more)

Great Meetings

2013-03-15T10:08:00Z

We all know what a great meeting feels like: we’ve solved a problem, decided on a course of action, aired differences, repurposed and refocused, or learned something important. We leave the meeting feeling energized, refreshed, important, and valuable. We have a renewed sense of teamwork, faith in management to solve problems, and an expectation of what actions will be taken before the next meeting. We have a feeling not just that something will be done, but the right thing will be done, at least...(read more)

Gripe Sessions

2013-03-11T10:06:00Z

Meetings are supposed to be opportunities to realign, reassess, and repurpose. They can be a pit stop for a team to check the map, kick the tires, and make sure the bus is on track. But we’ve all been to too many meetings that end up being a demolition derby of mud slinging, tires spinning, fender benders, and totally pointless destruction. I worked at a place where everyone dreaded lab meetings because if one person was there (I’ll call him Mike), the meeting became “The Mike Show.” Mike spent most...(read more)