A New York Times article cites studies of how much time we waste on the job. Microsoft: 16 out of 45 hours in a work week. America Online and Salary: two out of three days a week. Steve Pavlina, a self-proclaimed work expert: we work only one and a half hours a day. Paradoxically, we spend more time at work: the average professional work ...

In our laboratory, a big drop in hemoglobin or platelet within 24 hours is a critical value, regardless of numbers. Essentially, we have added a critical delta check for these analytes, e.g. a platelet count of 10,000 vs. a change from 400 to 150 thousand. Why not apply this logic to more tests? As I recently blogged, some labs no longer repeat ...

A nurse from our Emergency Department walked into my office recently and said, “I feel we have a good working relationship with the lab, and I don’t want to write this up. I would rather just talk about it.” OK, I supposed. She continued, “We didn’t order tests STAT on a patient we had today, and so you didn’t see the tests on your end. The ...

We’ve been tracking ED turnaround time for a while. Our study was originally designed to be narrow enough to isolate variables: we tracked only STAT BMP and CMP panels, chose optimum staffing between 0900 and 1600, and wanded specimen barcodes at drop off. Since our ED collects specimens before or after orders are placed, we tracked specimen ...

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 ...

A hospital receptionist concerned about a lab report on her son came into the lab asking what a ''bicarb'' level meant. I printed a page from Lab Tests Online, a resource I often use for patients. When I walked it down the hall to her desk, she was putting down a telephone. ''That's OK,'' she said. ''I just ...