Stepwise Success : CLS in the News

The Right Specimen

Scott Warner — Fri, 19 Jun 2009 10:09:00 GMT

The New York Times reports that a laboratory sent letters to nearly a thousand patients for redraws after six patient samples on six specific days in a nine-month period were discovered as mislabeled. A hospital spokesman describes them as "isolated incidents,"...(read more)

A Good Job

Scott Warner — Mon, 27 Apr 2009 10:13:00 GMT

The Bureau of Labor Statistics (BLS) report on unemployment is enlightening. A table lists different categories of the unemployed. The "official" rate is a percent total of the civilian labor force. That's 8.5% as of March. But the total including "marginally...(read more)

The Press

Scott Warner — Fri, 18 Apr 2008 13:49:00 GMT

I sometimes wonder why an evening newscast devotes so much time to what the weather might do and so little to all the neat stuff happening under all that weather. Then it hits me like an extra of the Times. The news is a mile-wide, inch-deep phenomenon. Journalists can't know everything, especially if understanding isn't condensable into a ten-second sound bite. The common ground of most stories, then, is human misery.

Which makes the weather a story of hope, I suppose. Still, I often cringe:

"The number of MRSA cases in Maine is hard to pinpoint because hospitals are not required to report them to the state." Portland Press Herald
"... advocates for improved screening argue that the MRSA legislation is necessary because hospitals are moving too slowly in screening patients." The Baltimore Sun.
"MRSA is responsible for more deaths than AIDS in the United States." Columbia Tribune
"Ten patients a day killed by C. diff bug." The Telegraph
"The proportion of death certificates mentioning Clostridium difficile (C diff) rose by 72%." The Guardian

Hospitals, apparently, are cesspools. And if a bug in the hospital makes us sick, it must be because that bug is there and not here--not because we are sick to begin with. Hospitals struggle not only with containment but control, almost impossible in a public environment where handwashing is the biggest unknown. For microbiologists, it's old news.

But for patients, it's frightening. These stories manage to offer just enough information without perspective to scare most sane people. "Flesh-eating bacteria" says it all.

As healthcare professionals, we should be proactive with the general press to educate the public. A local column explaining what new services are offered at the hospital, a newsletter, patient brochures, and even a blog are excellent vehicles.

How do you handle the press? Are you involved with your hospital's marketing? And if so, are you successful in informing and reassuring the public, making you a caregiver of choice?

A New Work Perspective

Scott Warner — Tue, 19 Feb 2008 17:03:00 GMT

Law and medicine careers may be losing self-respect, according to this article in the Dallas News. While these professions are still solidly supported by pay, security, schooling and responsibility, there is a sense that their status is waning.

Excerpt:

This decline, Mr. Florida argued, is rooted in a broader shift in definitions of success, essentially, a realignment of the pillars. Especially among young people, professional status is now inextricably linked to ideas of flexibility and creativity, concepts alien to seemingly everyone but art students even a generation ago.

"There used to be this idea of having a separate work self and home self," he said. "Now they just want to be themselves. It's almost as if they're interviewing places to see if they fit them."

Arguably, such a shift may be more noticeable in high-profile professions. There are a number of spins. For the laboratory, this means recruiting students who may have different assumptions than previous generations. There may have existed a want for a steady job, a prestigious career or a stepping-stone to other professions. "I just want to be myself" is a new paradigm.

I wear a dress shirt and tie at work, for instance. Why? Because it is my work self. My home self is different in many ways, dress being one example. Will the new generation of laboratory technicians and technologists be different?

It's easier for someone of my generation to dismiss this as a change in "work ethic," when there may be something more fundamental going on: a new perspective on the value of work.

If this is correct and professional status has become a matter of personal expression, then this changes what working in a laboratory means. This will echo in recruiting strategies and, ultimately, in how laboratories are managed to ensure the best patient care possible.

Maine's HealthInfoNet

Scott Warner — Thu, 31 Jan 2008 14:45:00 GMT

The first statewide electronic health information system, HealthInfoNet, was recently unveiled in Maine as reported here. This is a logical application of technology, an accelerating trend of making healthcare information--including prescriptions--available to clinicians, but also letting patients know who sees their information and why. Such infrastructure enables health information to follow the consumer: a revolution in medicine.

For the laboratory, electronic consolidation is good. In the blood bank, for instance, an accurate history is critical. Local errors may include transcription error, misfiled cards, or data corruption.

But the real problem is larger--how do we know another laboratory didn't detect a significant alloantibody? For small hospitals with limited surgical services, this may be more likely. And a patient interview is no guarantee. A statewide system--and larger--will eventually help reduce risk and make transfusions safer.

For managers, sharing patient history is a first step in greater quality control. Imagine linking instrument data in real time--a logical extension of online access to patient and peer reports. Imagine delta checking across hospitals, tracking lot to lot variation, tracking regional shifts and trends, and real time review of abnormal results by pathologists. The end result--more reliable results--means better patient care.

Our concept of systematic error may change. We may see local, regional and wide area systems generating quality information to prevent errors. Biases in your laboratory that affect most or all results--temperature, water quality, humidity, human error--may be detected real time as the wider system updates. It is a tantalizing possibility.

Today's dreamers create the future. Think about the changes you have seen in the laboratory during your career. What is possible tomorrow?