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  • Three or Four Steps

    When we went paperless in order entry, it meant much more than just dumping paper, binders, index cards, labels, and hand-carried requisitions. Since all staff needed this information, each person had to have the right computer skills to use Access, search folders on the server, copy and paste, cut and paste, drag and drop, use wildcard ...
    Posted to Stepwise Success (Weblog) on January 17, 2014
  • If This, Then That

    The early days of artificial intelligence promised much. In 1987, Lotus unveiled HAL (named after the maniacal computer in Kubrick’s 2001, a letter off from IBM) that used a natural language interface to communicate with users. The Chicago Tribune reported, “Type ‘graph this’ and you get a graph.” Twenty six years later I tell my phone, “Show ...
    Posted to Stepwise Success (Weblog) on December 16, 2013
  • From Bands to Grans

    We’ve come a long way since the days of a patient arriving in the ED with belly pain and going to the OR based on an imprecise band count. Imprecision can be estimated mathematically as: 2 Standard Deviations = 2 x SQRT((# cells x (100 - # cells)) / total cells counted) Thus, counting nine bands in a 100-cell differential has a theoretical ...
    Posted to Stepwise Success (Weblog) on December 11, 2013
  • To 41s or Not 41s?

    James Westgard writes on his web site, “Multirule QC uses a combination of decision criteria, or control rules, to decide whether an analytical run is in-control or out-of-control. The well-known Westgard multirule QC procedure uses 5 different control rules to judge the acceptability of an analytical run.” One of these is the 41s rule. A 41s ...
    Posted to Stepwise Success (Weblog) on November 22, 2013
  • Story Time....on the IPAD!

    I'm sure that most of us know that narrative language skills (the ability to tell/retell and understand stories) is a huge predictor of school success. One of the great things about being a school SLP, is that story telling and stories are a big piece of curriculum (and common core!) and it's not difficult to work on stories in a variety of ways. ...
    Posted to Speech in the Schools (Weblog) on October 28, 2013
  • 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
  • How Much QC is Enough?

    Laboratories perform a lot of instrument quality control. Hematology analyzers have at least three levels of QC performed on one or more sampling modes, patient controls, and built-in trending (X-bar cumulative averages). Urinalysis and coagulation analyzers have 2 levels of control. Chemistry uses the most commercial material with 2 or 3 ...
    Posted to Stepwise Success (Weblog) on August 30, 2013
  • Pass the Calculator

    “Have you seen the brain?” is what I hear when people need a calculator. In this age of central information systems, onboard calculators, PCs, and smartphones, the dollar store calculator is still indispensable, those with bigger keys and displays more so. Except, of course, when the brain goes missing. Small and lightweight, calculators are ...
    Posted to Stepwise Success (Weblog) on July 19, 2013
  • Precision vs. Significance

    I can still hear it, that tickita, tickita, tickita of the BBL Fibrometer. One site claims, “With the use of this convenient and precise device, you can achieve rapid and accurate results within a short period of time.” And be driven loopy by the noise. As we know, accuracy and precision are relative concepts. The Fibrometer was a step up ...
    Posted to Stepwise Success (Weblog) on July 15, 2013
  • Have You Discovered Dropbox?

    In my last blog, I wrote about the possibility of a professional change, and yes, in the time since, I have decided to make a change. It was not an easy decision, but I look forward to approaching my services through a slightly different lens. It was not only difficult cleaning out  my office of 16 years but also my computer!  As ...
    Posted to Speech in the Schools (Weblog) on June 26, 2013
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