News, Analysis, Trends, Management Innovations for
Clinical Laboratories and Pathology Groups

Hosted by Robert Michel

News, Analysis, Trends, Management Innovations for
Clinical Laboratories and Pathology Groups

Hosted by Robert Michel
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Felder Predicts Clinical Laboratory Automation to Become Faster, More Efficient

Laboratory automation technology is ready and about to move into production

Most large clinical pathology laboratories in the United States and other developed nations now have a decade or more of experience with laboratory automation. In response to what is now a substantial market for laboratory automation, in vitro diagnostics (IVD) manufacturers are preparing to introduce the next generation of laboratory automation.

“Lab automation is a market, particularly in Asia, that has reached what we call mid-level maturity. It is no longer unusual to have an automated laboratory, it’s almost routine. Today, the question is ‘what’s next?’” observed Robin A. Felder, Ph.D. , publisher of Medical Automation and Professor of Pathology and Associate Director of Clinical Chemistry at the University of Virginia in Charlottesville, Virginia.


The Joint Commission Explains Patient Identification Requirement Changes

Response to comments from Dennis Ernst of the Center for Phlebotomy Education

Recently Dark Daily alerted clinical laboratory readers to a decision by The Joint Commission to change their requirements for patient identification. Included was the opinion of Dennis Ernst,  MT(ASCP), long time Director of the Center for Phlebotomy Education, that The Joint Commission’s decision to change patient identification requirements was a step backwards in patient safety. (See Dark Daily, “Joint Commission Changes Requirement for Patient ID during Blood Draws” ).

In particular, Ernst was troubled that the new patient identification protocols no longer require a healthcare worker to have the patient state his or her name before blood is drawn. He contacted The Joint Commission to inquire about this change. He related to Dark Daily that officials at TJC had informed him that, in their surveys of clients, there was a feeling that this specific requirement was “burdensome and unnecessary.”


Underfunding Affects the Public Face of Clinical Laboratories

Noted Humorist Garrison Keillor Encounters the Truth of Inadequate Funding for Clinical Laboratory Testing Services

It is widely recognized by pathologists and clinical laboratory managers in the United States and abroad that medical laboratory testing is a “high touch” clinical service. Each day, lots of patients interact with laboratory professionals to provide specimens. Physicians know that their own successful medical practice is dependent on a smooth-functioning and high-quality pathology testing service that delivers accurate, reliable lab test results.

Another truth in today’s healthcare system is selective underfunding of certain clinical laboratory testing services in the United States. In this country, pathologists and clinical lab managers are all too familiar with this situation. What might be at the top of the list of inadequately-reimbursed laboratory procedures is venipuncture. It has been years since Medicare, Medicaid, and private payers have reimbursed the venipuncture procedure at a level that is close to the cost of providing that service to patients.


Joint Commission Changes Requirement for Patient ID during Blood Draws

Center for Phlebotomy Education says new requirement is step backward for patient safety

When The Joint Commission recently changed the patient identification requirement for drawing a blood sample, one national phlebotomy leader considered it a step backward in patient safety.

“Per a revised policy issued by The Joint Commission, it is no longer required for the phlebotomist or person drawing the blood to actively involve patients by, for example, asking them to state their name,” commented Dennis Ernst, MT(ASCP), the long-serving Director of the Center for Phlebotomy Education. He’s one of the leading observers of phlebotomy trends and he’s concerned about what this means to patient safety.


Inventive Phlebotomist Creates Order of Draw Bracelets to Wear as a Reminder

Like other areas of clinical laboratory operations, phlebotomy must perform flawlessly. That’s particularly true because phlebotomy is often the only point of contact a patient has with the laboratory. Phlebotomy has its own complexities which often take a dedicated phlebotomist years to master. That’s why a clever new invention may be of interest to clinical laboratory managers and phlebotomists everywhere.

The invention is called the order of draw bracelet. These bracelets are created with brightly colored beads to remind phlebotomists of the appropriate order of draw for Vacutainer/Syringe draws. The beads come in a variety of types and sizes, and the bracelets are appropriate for both women and men.

Pam VandeDrink, a Phelbotomist for Laboratory Corporation of America, came up with the idea for order of draw bracelets when she was a student at Boston Reed College in Napa, CA. She witnessed a little girl beading pipe cleaners and plastic beads to match the order of draw colors in her textbook. “At the time, I was trying to use a color story that I had taught myself as a memory device for the order of draw colors,” said VandeDrink. “The bracelet became a much faster, easier, and more visible way for me to remember.”

In manufacturing the order of draw bracelets, VandeDrink keeps the materials she uses modest so that the cost of the bracelets is low. That’s because students and newly-trained phlebotomists often do not have much money coming out of school. However, VandeDrink plans to launch a “fancier” version of the bracelet for more established phlebotomists in the future.

Order of draw bracelets are becoming popular with phlebotomy instructors, who purchase them as graduation gifts for their students. Fletcher Allen Health Center in Burlington, VT “bought the order of draw bracelets for our team of 44 phlebotomy staff, both inpatient and outpatient,” according to Lynn Bryan of Fletcher Allen. “We partner in training students from the University of Vermont Laboratory Sciences program and the bracelets really help as a visual aid for the students.”

Dark Daily wanted to recognize VandeDrink for her invention and her entrepreneurial spirit. VandeDrink’s order of draw bracelet is the kind of low-tech, high value idea that simplifies a complex process and improves quality of care. Clinical laboratories are always looking for solutions and opportunities to improve quality and benefit patients. Order of draw bracelets are certainly a cost-effective solution to the further reduction of phlebotomy errors. It’s not surprising that labs like Fletcher Allen are making them available to their entire phlebotomy staff.

PS: Dark Daily is always interested in the clever management ideas and inventions that generate great benefit in clinical laboratory operations. Feel free to contact us with your laboratory’s innovations and successes.

PPS: One hospital which has achieved a zero error rate for patient identification with lab-managed phlebotomists is Ingalls Memorial Hospital in Harvey, IL. Marilyn Nelson, Director of Laboratories at Ingalls, will be at the Executive War College on May 10-11 to share how this was achieved, using a tightly-integrated informatics system that cues phlebotomists at the time of the draw, then guides the specimens directly into the lab and onto the analyzers. Full details on Nelson’s presentation can be found at