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  • Laboratories Lead the Fight Against Zika

    We are rapidly approaching Medical Laboratory Professionals Week, (MLPW), the annual celebration of the medical laboratory profession, and those who play such a vital role in the delivery of quality healthcare. It has been celebrated annually since 1975, during the last full week of April, and once again, the vital role of the laboratory is ...
    Posted to CRI Lab Quality Advisor (Weblog) on March 18, 2016
  • Controlling Specimen Identification Errors: A Quiz

    It is a well-known fact by now that most laboratory errors occur in the pre- and post-analytic phases of testing and that these errors can have a significant impact on patient care. Often, these activities do not occur within the physical confines of the laboratory, but in other locations—often by personnel not directly managed by the ...
    Posted to CRI Lab Quality Advisor (Weblog) on October 26, 2015
  • Do You Look At Charts?

    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 morning we take 15-30 minutes to round at the nursing stations to check a few charts, among ...
    Posted to Stepwise Success (Weblog) on February 4, 2015
  • Order Entry Errors

    One of our more common complaints is that we didn’t do the correct test. We missed a test because it was not seen, illegible, or written on the back of a two-sided form; we assumed an abbreviation meant something unintended by the physician; we entered an order incorrectly into our information system. In very few cases do we forget to perform a ...
    Posted to Stepwise Success (Weblog) on December 19, 2014
  • Get Back to Basics: Ebola and Other Things

    It is extremely important to get back to basics in whatever we do. This simple edict is so often ignored because- well, because it is so basic. We tend to go for the complicated and glitzy. I thought about this truism when the CDC issued its new more rigorous guidelines this past Monday. There is nothing really complicated about the ...
  • Is Your Lab Prepared for Ebola?

    Just a few short months ago Ebola was a disease in a far away continent. The greatest fear was that with our internationally mobile population a case or two might slip into the USA. Then 2 Americans in Liberia contracted the disease and were flown back amongst great fanfare to Atlanta's Emory Hospital where they were treated for several weeks, ...
  • Does Tech Support Believe You?

    More times than I can count I’ve discovered a problem with an instrument because of an unexpected shift or trend in quality control, called tech support, and been told there isn’t a problem. Recently a hematology field service tech told our techs that a shift wasn’t a shift, and (basically) that none of us knew what we were looking at. He ...
    Posted to Stepwise Success (Weblog) on March 19, 2014
  • All The Other Labs Do It

    We report an estimated GFR using the MDRD (Modification of Diet in Renal Disease) equation. Sometime last year we stopped reporting the value in patients over seventy, because it hasn’t been validated for that subset of patients. It can still be useful, but it can also be misleading. Curious providers can use online calculators, preferable to ...
    Posted to Stepwise Success (Weblog) on January 31, 2014
  • Questioning Physicians

    The other day a physician ordered a platelet count to be recollected and repeated off lavender and blue top tubes. The patient platelet count had dropped from 229 thousand to 102 thousand in 24 hours, a sudden change. The tech performed the work but grumbled to me the next morning. “He doesn’t trust our lab results! I told him there was ...
    Posted to Stepwise Success (Weblog) on September 4, 2013
  • ABO Compatibility Safeguards

    The incidence of ABO-related transfusion complications is rare but significant. One study estimates 800-900 cases annually in the US, with most causes being identification or phlebotomist error. Considering that undetected errors can occur depending on the patient type e.g. a group A patient may safely receive a unit of O in error, the true rate ...
    Posted to Stepwise Success (Weblog) on July 5, 2013
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