ASCLS Today Volume 32 Number 2

Janelle M. Chiasera, PhD, ASCLS Region III Director

Fifteen years after the release of the Institute of Medicine’s (IOM) landmark report, To Err Is Human: Building a Safer Health System, a follow-up report released by the IOM in 2015 makes the case that the delivery of health care continues to proceed with a glaring blind spot, diagnostic errors. If you recall from their report in 2000, the IOM not only revealed the common fact that all humans make mistakes, but they brought to light another important obvious fact, that those of us in health care, as human beings, are also prone to make mistakes. After the release of the report in 2000, a new trend began in healthcare organizations, one focused on addressing the safety and quality of healthcare. Dial forward fifteen years and this could and should result in a paradigm shift in our role as medical laboratory scientists and, more importantly, the role we will play in defining, communicating, and providing evidence for the impact of the contribution we will make to healthcare moving forward. 

The 2015 IOM report focuses on three important major topics. First, this report uncovers a critical type of error in healthcare – diagnostic error – that has received little to no attention since the To Err is Human report. The report outlines some reasons as to why this may be the case including sparse data, few reliable measures, and the fact most errors are identified in retrospect. Regardless, the IOM believes the most important contribution they can make in this report is to highlight the importance of the issue and to direct discussion among patients, healthcare professionals, and healthcare administrators. Second, the IOM believes patients and their families are central to the solution and, as such, they recommend healthcare organizations develop partnerships with patients and families to help improve diagnosis. Third, the IOM emphasizes the diagnostic process, human health, and human disease are very complex and, because of this complexity, require intra- and inter-professional teamwork and collaboration for the efficient and effective delivery of healthcare currently and in the future.

The report identifies five issues that will reduce diagnostic errors:

• Healthcare professional education and training does not take fully into account advances in the learning sciences. The report emphasizes training in clinical reasoning, teamwork, and communication.
• Health information technology, while potentially a boon to quality healthcare, is often a barrier to effective clinical care in its current form. The report makes several recommendations to improve the utility of health information technology in the diagnostic process specifically and the clinical process more generally.
• There is little data on diagnostic error. The report recommends, in addition to specified research, the development of approaches to monitor the diagnostic process and to identify, learn from, and reduce diagnostic error.
• The healthcare work system and culture do not sufficiently support the diagnostic process. Echoing previous IOM work, the report also recommends the development of an organizational culture that values open discussion and feedback on diagnostic performance. 
• In addition, the report highlights the increasingly important role of radiologists and pathologists as integral members of the diagnostic team.

Finally, the report provided eight goals to improve diagnosis and reduce diagnostic error

Goal 1: Facilitate more effective teamwork in the diagnostic process among healthcare professionals, patients, and their families

Goal 2: Enhance healthcare professional education and training in the diagnostic process 

Goal 3: Ensure that health information technologies (IT) support patients and healthcare professionals in the diagnostic process 

Goal 4: Develop and deploy approaches to identify, learn from, and reduce diagnostic errors and near misses in clinical practice

Goal 5: Establish a work system and culture that supports the diagnostic process and improvements in diagnostic performance

Goal 6: Develop a reporting environment and medical liability system that facilitates improved diagnosis by learning from diagnostic errors and near misses

Goal 7: Design a payment and care delivery environment that supports the diagnostic process

Goal 8: Provide dedicated funding for research on the diagnostic process and diagnostic errors

Given the importance of the diagnostic process to patients and to health care decision-making, as well as the pervasiveness of diagnostic errors in practice, it is surprising this issue of diagnostic errors has been neglected within the quality improvement and patient safety movement of the past decade. Regardless, this is our time. This is our time because the environment around us is changing and those around us are calling us to action. We can respond in two ways, we can remain inside the laboratory and continue to do things as we always have, or we can answer this call to action together by defining the contribution we will make. I leave you with one of my favorite quotes and challenge you to take a role in answering this call. 

“If you always do what you’ve always done, you’ll always get what you’ve always got.” 
Anonymous

Ally Storla, MLS(ASCP)^CM, ASCLS Georgia President-Elect
Debora Ardis, MT(AMT)

Medical Laboratory Professionals Week (MLPW) is an exciting time of the year. This year, MLPW will be held April 22 through 28. Every hospital is different and for some, MLPW is overlooked or under-celebrated but it doesn’t have to be! We’ve compiled a list of low-cost activities and fundraisers below to help you make the most of your hospital’s MLPW. Consider volunteering to help plan MLPW at your hospital; be the change you want to see! 

Games and Activities 

• Lab Week Run/Walk: Take Medical Laboratory Professionals week out of the lab and celebrate with a 5K Fun Run/Walk in conjunction with the ASCLS fundraiser Lab Week Run. Lab Week Run is a virtual run that can be completed anywhere, anyway, anytime during lab week. Last year participants hiked and kayaked in addition to running and walking. All funds raised help the Student and New Professional New Member Forums and all participants get an awesome, laboratory themed finisher medal! Visit www.labweekrun.com to learn more.
• Price is Right: In Price is Right style, pick a few common laboratory items such as gloves, coats, pipette tips, reagents, etc. and let employees guess the costs. The winner is the one who guesses closest without going over. This game also has a double benefit of helping laboratory personnel discover the costs associated with laboratory supplies and can help reduce waste. (Submitted by Lacey Campbell.)
• It Belongs to Me: Create a list of odd objects that employees own, or used to own, that would be considered unexpected. (Examples: crazy cat lady action figure, Venus fly trap plant, glow in the dark toilet paper, popcorn scented pillow, potty putter, dinosaur bone, 8-foot cardboard cut-out of a celebrity, ostrich egg, samurai sword, celebrity hair lock, paper doll collection, etc.) Find images of the objects online, print out the information and create a board, listing the objects randomly in one column and a list of lab personnel randomly in another column. Create a form for everyone to fill out and enter their guesses; put a submission box by the board and let everyone guess which object belongs to which person. The winner(s) will be those who guess the most correctly.
• Before I Worked in the Laboratory, I Worked…: Anybody that wants to participate writes out a job or career they had before working in the laboratory and others will try to guess who matches the job. You’ll need a board with two columns, one for the job name and another column for the laboratory personnel names. Put a box by the board with paper and pen and let everyone guess. 
• Find the Critter – with or without Scavenger Hunt: This game is played by hiding little critters all over the lab which when found, can be exchanged for a prize. This can be done either by simply hiding handmade ‘critters’ around the laboratory, blood bank, phlebotomy office, and histology laboratory or by creating a scavenger hunt with clues as to where the critters have gone. For large laboratories, it can be helpful to create a list of clues about where each critter is hidden. Whoever finds the critter can exchange it for a prize. Our hospital had many staff members donate prizes (these are often trade show giveaways) and distribute prizes to the different areas’ managers for their employees when they found a critter. The best part of this game is when suddenly a nearby employee loudly proclaims “I found a critter!” We made critters with googly eyes, plastic foam, glitter pom-poms, and other assorted affordable craft supplies. In addition to creating 3D critters we had flat critters that could be hidden in procedure manuals and in more creative places. You can also create “Wanted” posters featuring photos of your critter creations lurking in the laboratory.
• Guess the Tech: Our laboratory has played this game a few different ways. In past years, we have based this game on a baby photo, a pet photo, or even a random up-close body part such as an eye, a nose, a hand, etc. and these have been very popular and fun ways to get to know coworkers. (Submitted by Ally Storla.)
• Daily/Weekly Contests: My lab often hosts guessing contests with candy in a jar, costume themes every day of the week (such as twins, celebrities, etc.), and a cake walk.
• World Map/USA Map: In the break room we set up a map of the United States and a World Map on our bulletin board and provide push pins and paper with instructions for laboratory personnel to post their name and birthplace on the map. Our lab did this for MLPW 2016 and we discovered that we work with laboratory personnel from all around the globe!
• Decorate: We decorated our laboratory break room with printed out laboratory memes from Lab Humor and the internet. Remember to keep the memes professionally appropriate (i.e. avoid disparaging other hospital professionals, no profanity, etc.).

Fundraising 
Short on funds for MLPW? Here are some ideas to help boost your Lab Week budget: host a bake sale, plan a silent auction, or have a chili cook off competition and charge $5 a plate with first, second, and third place winners. Important: Be very careful to try to include off shifts (weekend only workers, evening shift, night shift) whenever planning Lab Week activities.
Educational Events and Lunch-and-Learns

• Reach out to your laboratory local sales representatives for companies your hospital is acquainted with. For example, if your Hematology department uses Sysmex, reach out to your Sysmex rep and schedule meals/education events. Be sure to remember the evening shift, night shift, and weekenders!
• Host events inside or outside of your lab to promote laboratory education to non-laboratory personnel. Offer prizes/snacks as incentives for participation. Example: Our laboratory manager created a board demonstrating the appropriate labeling of common laboratory specimens and gave everyone who watched her presentation a laboratory pen—this event was very educational, interprofessionally positive, and well received by hospital staff.
• Some laboratories bring MLPW to the floors with baked cookies/muffins to every nursing station.
• Invite non-laboratory personnel on a tour of the laboratory! Show them each station and give them a brief description of the work being done.

At the end of the day the best way to get the most out of your MLPW is to begin planning early. Be creative, be inclusive, and have fun!

Louann Lawrence, DrPH, MLS(ASCP)^CM, Education and Research Board of Trustees Chair

It is time to consider application for 2018 Education and Research (E&R) Fund grants and scholarships. Please encourage undergraduate and graduate students whom you know, as well as ASCLS members doing research, to apply. Application forms and instructions are available at www.ascls.org/awards and the deadlines are April 1 for scholarships and May 1 for grants. 

Please print and mail your scholarship applications with accompanying transcripts and references to:

Joe Briden
Alpha Mu Tau Fraternity Executive Secretary
7809 South 21st Drive
Phoenix AZ 85041-7736

Joe processes scholarship applications for both E&R and Alpha Mu Tau Fraternity (AMTF). 

Please e-mail your grant applications to ASCLS Executive Vice President James Flanigan at jimf@ascls.org.

Contribute!
What better way is there to meet your charitable goals than to support our developing professionals? You can use the DONATE button that appears on www.ascls.org to make your contribution to the E&R Fund, or simply mail your check to the national office:

c/o James Flanigan
American Society for Clinical Laboratory Science
1861 International Drive, Suite 200
McLean VA 22102

Though your contribution is officially a tax-deductible donation to our 501c3 fund, it is more accurate to think of it as an investment in our profession.

DCLS Scholarship
The newest effort being considered is to support those brave doctoral students studying for the DCLS. There is no specific graduate support for these individuals who will be the vanguard for this advanced level of practitioner in our field. The E&R Fund would like to be home for this effort, with your support. Specify “DCLS” when you donate if you wish to help build that endowment fund.

E&R Grants and Scholarships 2017 Report
The ASCLS Education & Research Fund, Inc. awarded two research grants and six scholarships in 2017, thanks to your contributions. This is the fourth year in which scholarships have been made in honor of Dan Southern and in memory of Michelle Kanuth, and the second year to give an undergraduate a Bernadette “Bunny” Rodak Memorial Scholarship. Dan, Michelle, and Bunny served as E&R Trustees and both Dan and Michelle led the fund as Chair. Friends and colleagues are invited to honor Dan and memorialize Michelle and Bunny by contributing to these scholarships.

This is the sixth year for our Edward C. Dolbey scholarships, given from a charitable trust bequeathed to the ASCLS E&R Fund in 2011 on behalf of Mr. Dolbey, who for many years was a prominent laboratory supplies distributor in Philadelphia and a long-time supporter of all things related to medical laboratory science. These scholarships support both graduate and undergraduate education.

The E&R Fund Memorial MLS Scholarship is intended for contributors who wish to honor or memorialize a colleague, friend or family member with a gift in his/her name. The recipient receives, in addition to the scholarship, a letter with the donors’ and honorees’ names. If you would like to contribute to the Memorial Scholarship, address your check to the ASCLS E&R Fund, or use the ASCLS DONATE page, designate the E&R Fund Memorial MLS Scholarship, and provide the name of your honoree.

2017 Scholarship Winners
The 2017 Daniel K. Southern MLS Scholarship recipient was Nicole Dispensa from Illinois. The Michelle S. Kanuth MLS Scholarship recipient was Emily Nagel from South Dakota and the Bernadette Rodak Memorial Scholarship recipient went to Sadaf Ahmad from New York. The Edward C. Dolbey Graduate Scholarship went to Michelle Campbell from Minnesota while the Dolbey MLS Scholarship recipient was Maryssa Schleis from Nebraska. The Dolbey MLT Scholarship went to Kara Smolarek from Florida. The 2017 total of scholarship awards supported by your contributions was $10,500. 

2017 E&R Fund Grant Awardees 
The E&R Fund Grant program attracted five applications for the Member Research Grant and one for the I. Dean Spradling Graduate Research Grant. The Member Research Grant was awarded to Nilanjan Lodh from Marquette University for a proposal titled Point of Care Diagnosis for Schistosomiasis from Urine by LAMP. The I. Dean Spradling Grant was awarded to Brian Deck from Michigan State University for The Viability Effects of Incorporating Opioid Peptide [D-Ala2,D-Leu5] Encephalin into Peripherally Collected Hematopoietic Stem Cells. This represents $8,000 in grant funds awarded. Our E&R Trustees were impressed by the quality of all the proposals, and truly wish we could have awarded all who applied. We strongly encourage masters and doctoral students to apply!

ASCLS invites all members to present their research or other relevant findings at the Annual Meeting Poster Competition to be held during the 86th ASCLS Annual Meeting in Chicago, Illinois. The purpose of the event is to allow ASCLS members an opportunity to present scientific posters while encouraging friendly competition. It also provides a venue for laboratory educational programs to showcase their students’ work in a poster format. 

Any student (undergraduate or graduate), faculty member, or practitioner who is an ASCLS member may submit an abstract to be considered for poster presentation. Institutions are not limited to a certain number of submissions. Abstracts will be reviewed by a committee. Professional members and graduate students have the option to present their posters without participating in the competition. 
The presentations will be judged by peer-review onsite and awards will be given in the following categories: professional member, graduate student, and undergraduate student. 
The winners will be announced during the member awards ceremony at the ASCLS Annual Meeting. The graduate student and professional member winners will each receive a complimentary, one-year Professional I membership in ASCLS. The undergraduate student winner will receive a cash prize of $500 to be awarded by the ASCLS Education and Research Fund and a complimentary First Year Professional membership in ASCLS. 

The submission deadline is April 2, 2018. Complete submission guidelines and instructions may be found at www.ascls.org/AnnualMeeting. Guidelines can be found by clicking on the folder titled “2018 Call for Abstracts.” Any further questions can be directed to Karrie Hovis, ASCLS Director of Professional Development and Project Management, at karrieh@ascls.org.