ASCLS Today Volume 32 Number 6

Janelle M. Chiasera, PhD, Region III Director

The Institute of Medicine (IOM) issued a recommendation to move healthcare institutions toward becoming high reliability organizations (HROs). An HRO is defined as an organization whose clients can count on the organization to perform as it has advertised.

The industries first to embrace the HRO concepts were those in which past failures had led to catastrophic consequences, such as airplane crashes, nuclear reactor meltdowns, and other such disasters. These industries found it essential to identify weak danger signals and to respond to these signals strongly, so system functioning could be maintained, and disasters could be avoided.

In terms of healthcare, when hospitals or clinics achieve HRO status, they consistently provide the best quality care, every single time, avoiding potentially catastrophic errors.

High reliability concepts are tools that a growing number of hospitals are using to help achieve their safety, quality, and efficiency goals. HRO concepts are not improvement methodologies, such as Six Sigma or Lean, rather they are insights into how to think about and change the quality and safety issues faced by the healthcare community.

At the core of HROs are five key concepts essential for any improvement initiative to succeed:

• Sensitivity to Operations
• Reluctance to Simplify
• Preoccupation with Failure
• Deference to Expertise
• Resilience

Figure 1: The Five Dysfunctions of a Team and How to Overcome the Dysfunctions

The IOM has called for effective teamwork under the “deference to expertise” concept as HROs cultivate a culture in which team members and organizational leaders defer to the person with the most knowledge relevant to the issue they are facing.

Much has been written about the process of building highly functional teams, and two critical truths remain clear. First, genuine teamwork in most organizations remains elusive; and second, organizations fail to achieve teamwork because they fall prey to pitfalls.

Patrick Lencioni in his book, The Five Dysfunctions of a Team, writes a compelling fable offering a simple yet powerful message for those who strive to be a high functioning team. He calls the pitfalls the five dysfunctions of a team and explains that organizations with highly functional teams have figured out how to overcome the five dysfunctions (see Figure 1).

In 2016 Lencioni published a follow-up book, The Ideal Team Player. In this book, Lencioni makes the case that some people are better at being team players and better at embracing the five behaviors to overcoming the five dysfunctions than others. Lencioni further explains these people are not born this way, but, either through life experiences, work history, or a real commitment to personal development, they have all come to possess three underlying virtues that enable them to be more successful.

Those three virtues are, hungry, humble, and smart. As simple as these words may seem, they are not exactly what they appear.

Figure 2: The Ideal Team Player

Hungry: Ideal team players are always looking for more. More things to do, more to learn, more responsibility to take on. They almost never have to be pushed to work harder because they are self-motived and diligent.

Humble: Ideal team players lack excessive ego and lack concerns about status. They are quick to point out the contributions of others and slow to seek attention for their own. They share credit, emphasize team over self, and define success collectively rather than individually.

Smart: Ideal team players have common sense about people. They know what is happening in a group situation and how to deal with others effectively. They have good judgment and intuition around the subtleties of group dynamics and the impact of their words and actions.

Ideal team players are strong in all three areas and can be found at the intersection of the three virtues (see Figure 2). I encourage you to read The Ideal Team Player or visit the Table Group to utilize the resources and tools to assess your own behaviors related to the three virtues. The website provides a summary article, self-assessment, manager’s assessment, interview guide, and an interactive webinar to help you recognize and cultivate the three virtues in you and in others.

Which of these three virtues comes more naturally for you? Which virtues do you need to work on to make your greatest contribution? I hope that you will join me in developing ourselves as ideal team players.

Maria Rodriguez, MLS(ASCP)^CM

My high school counselor used to quote Pablo Neruda at the end of every academic year: “Nosotros, los de entonces, ya no somos los mismos.” This quote was his eloquent way of making us reflect on how everything is constantly changing.

At the time, I thought this phrase was the cheesiest thing I had ever heard. “We, of that time, are no longer the same.” What does that even mean? It was not until last year I realized how right he was.

The only thing constant in life is change, and our likelihood to succeed depends on our power of adaptability. We evolve to harmonize with our surroundings. Nonetheless, navigating those changes is not always smooth sailing.

Changes are usually subtle. They approach you slowly, so you have time to adjust to them. Nonetheless, some changes strike you like a lightning bolt. From one day to another, you are in a completely different situation.

Graduating from my Medical Laboratory Science program was one of those lightning bolt changes. One day I was a student living in Bozeman, a town located in southwest Montana. Three days later I was a new professional residing in Las Vegas.

For most of us, that’s how it works. One day we are shadowing seasoned MLSs, and the next day we are running departments by ourselves. It’s scary, I know. It even makes you question, “Am I ready for this?”

Soon, all the changes start to overwhelm you, as you are now dealing with a new job, new coworkers, and a new city. It feels like even breathing is not the same anymore. Then, an email pops up in your inbox with the subject line: “It is time to renew your ASCLS membership.” Your membership in the society you have been part of for almost your whole college career is about to expire. You wonder whether it’s worth it to renew your membership. You are going through enough already. Your routine has changed, and you feel maybe it’s time to take a break and focus on your job. Plus, the new membership fee is not in your budget. Does any of this sound familiar?

It’s not a secret that going from a student to a new professional can be hard. Nonetheless, for every reason you have not to renew your membership, I have a thousand reasons why you should.

Two Forums, One Goal
For starters, ASCLS has two forums that help students and new professionals find their place in the profession and the society. The Developing Professionals Forum (for students) and Ascending Professionals Forum (for new professionals) work hand in hand to provide students and new professionals a voice to express their ideas, opinions, and concerns. Both forums also raise funds to support travel grants for students and new professionals to attend the ASCLS Annual Meeting and Legislative Symposium.

The Developing Professionals Forum will be there through your college career. It will give you tips on how to find a job, how to study for the Board of Certification (BOC) exam, and more. Being part of the Developing Professionals Forum is only the beginning of a fantastic journey full of opportunities to grow not only as a laboratory professional, but also as a leader.

The Ascending Professionals Forum will be there to help you get through those stressful changes that come after graduation. Why go through all of that by yourself when you can do it with people who are going through similar situations? No one is going to understand you more than your fellow Ascending Professionals.

Change is a Constant
Remember what I said before? “We, of that time, are no longer the same.” Well, laboratory professionals, of that time, are no longer the same either. Part of the beauty of our profession is that it is always moving forward.

New diseases are being discovered, technologies are being developed, and standards and requirements are being revised and updated. The political climate is also constantly changing and shaping the profession. It is hard to keep up with so much innovation at once. Thankfully, ASCLS can help.

Attendance at the Annual Meeting is highly encouraged, but it’s not the only way to stay up to date with the Society and the profession. Publications, such as ASCLS Today, Clinical Laboratory Science, and the Developing Professionals Forum and the Ascending Professionals Forum newsletters will keep you informed with timely updates on Society activities, professional topics, and political issues.

On top of that, our new online member communities allow you to connect with hundreds of professionals with one click. Do you need help solving a complicated case? Write a question in the ASCLS Open Forum and you will get multiple responses from your colleagues all over the nation within a day.

Give Back to Your Profession
It is always a good time to advocate for your profession. We are the hospital’s best-kept secret. Thus, we united our voices to educate the public on what we do and the importance of lab professionals in the medical field.

Right now, it may seem like you don’t have time to dedicate to the Society. That is okay. You don’t have to withdraw from all the other benefits your membership offers. It’s always a good time to network with other members. It’s always a good time to keep yourself up to date with new trends and technologies linked to our profession. You can volunteer when the time is right for you.

The next time you wonder whether it’s worth renewing your ASCLS membership, I hope your answer is, “YES!” You will gain access to outstanding resources that will help you in your future endeavors. You will connect with seasoned professionals who are willing to share their knowledge.

Clinical laboratory science is changing; navigating those changes with your professional society will be the best investment of time and money you will ever make. In a life full of changes keep something constant. Renew your ASCLS membership!

Deb Rodahl, MBA, MLS(ASCP)^CM, ASCLS Past President

It has been my honor and privilege to serve as ASCLS president for the last year. I am a firm believer in the value that ASCLS brings to the clinical laboratory sciences profession and to the practitioners within this profession. ASCLS has helped shape who I am professionally and personally, for which I will always be grateful.

In my year as president I attempted to focus on the following areas that had been identified as a need in our organization.

Leadership Development: This is a major initiative in ASCLS with many facets. In the last year we have introduced several online training modules to provide our constituent society leaders with readily available resources on ASCLS leadership topics.

This year the Board of Directors received recommendations from the Root Cause Task Force, which has been working to determine the underlying issues impacting our ability to recruit leaders within our constituent societies. While many recommendations have been received and will be acted upon, the theme of simplification resonated with us. How can we make the work of the constituent societies less burdensome so that they can focus on their grassroots activities to engage our members?

The third component of work this year has been to establish a task force to evaluate the national Leadership Academy to determine how it fits in with our overall leadership development needs. I am excited to report that we are on course to have an updated academy program for 2019 and added clarity for the work of the Leadership Development Committee.

Mentorship: Last year we recognized the need to provide mentorship support for new leaders in ASCLS. One step toward this goal was to formalize the Mentorship Task Force by converting it to a full-fledged ASCLS committee. This conversion comes with an intent to expand the scope from providing mentorship for newer professionals in ASCLS to any member who also seeks support for an ASCLS leadership role they either have taken on or would like to take on. This could be at the constituent society level, regional level, or national level.

Just as we mentor new employees in our work environment, we should also provide support for ASCLS members who want to undertake a new role in our organization!

Communication: In July of 2017 our ASCLS members communicated very clearly how much they missed having a regular ASCLS Today newsletter, which has been a staple in our ASCLS communication offerings. We remained somewhat challenged to produce ASCLS Today through the end of 2017; however, with support from the ASCLS Board of Directors, we approved the addition of a director of marketing and communications to our ASCLS staff. This role has established a clear plan for our communication strategy within ASCLS and helped get us back on track with ASCLS Today.

Communication comes in many forms with many goals. Our ASCLS CONNECT Communities and the ASCLS Open Forum are perfect venues for pushing out time-sensitive information as well as uniting our members around common themes, causes, and topics. The traffic on our communities and forum increased significantly this year as people caught on to the value of this interaction. I was able to post timely updates and reminders, which is something I encourage our future leaders to continue to expand upon.

As we continue to evolve our communication and marketing within ASCLS, we are adding a new Marketing and Communications Committee to coordinate this work across our organization.

Professional Involvement: If you were at the House of Delegates last year, you heard me describe a short assessment tool where I scored as an ESTJ, which is also how I score on the Meyers Briggs. What I learned from my assessment, however, really highlights why I am here today. ESTJs are civic-minded workers who strive to improve society and like to be part of organizations. This was the “aha” for me—I am a “joiner” and learned early on that I need to get involved to gain the true value of “membership.”

My personal goal is to try and articulate not just the value of professional involvement but how critical it is for our profession to achieve our own professional visibility. We can’t continue to bemoan the lack of visibility if we aren’t willing to do something about it.

I am heartened by increasing attendance at ASCLS meetings. We had record attendance at the Clinical Laboratory Educators Conference (CLEC) this year and had more than 500 attendees at our Annual Meeting in Chicago. Our members have dialoged about the value of in-person meetings and most notably how “people join people.”

Our nation had many significant events this year that resulted in mass casualty victims being rushed to local hospitals. Behind the scenes are the laboratory professionals who are just as critical members of the teams that save lives. The story from Shannon Billings following the Las Vegas shooting said so much about our profession and the impact we have every day. Thank you, Shannon, for sharing that story with us. Now we all need to help spread that word!

I would also summarize this year as a year of change. We made critical decisions that should continue to propel ASCLS as the preeminent organization that represents our profession:

• Addition of a director of marketing and communications, which will significantly increase our ability to create a branding strategy.
• Transition of our Annual Meeting to be independent from the AACC Clinical Lab Expo, which allows us to move to different destinations around the country and offer more reasonable costs for our members. Please join us in Charlotte, North Carolina, June 23-27, for the 2019 Annual Meeting.
• Transition of the Clinical Laboratory Science journal to a new platform, which allows articles to be indexed on PubMed and move us to a fully-electronic “submission to publication” process.

This year required great attention to items in the government and regulatory arena as grassroots efforts around the Protecting Access to Medicare Act (PAMA) data collection methodology and the Centers for Medicare & Medicaid Services (CMS) Clinical Laboratory Improvement Amendments (CLIA) personnel standards took top priority when they surfaced. We are blessed with the tenacity and legislative prowess of our Government Affairs Committee that remains ever vigilant around what is happening within legislation or regulation that affects the laboratory. Have you ever tried to read the Federal Register? I am so grateful to have this group of volunteers keeping their vigilance. Add to that, the significant number of practitioners who responded to our requests for action to contact their legislators and speak out for our profession. It takes a village!

I have learned much in my year as ASCLS president but most notably how truly dedicated our members (and staff) are to our profession. We have seen our first Doctorate in Clinical Laboratory Science (DCLS) graduate, Brandy Gunsolus, share her experiences and the impact she made every day as a resident. Brandy is a pioneer in our profession. Behind that significant milestone is the work and dedication of several ASCLS members to develop the vision for an advanced practice degree and to create this amazing future. My hat is off to all of you!

As I reflect on my year as president, I think of it as a year of challenge, communication, and change. Volunteers within ASCLS continue to step forward to work on committees, task forces, and other special projects. I am humbled by the true depth and work of our ASCLS members. Family is important to me, and that includes my professional family. It is why I have made this commitment to ASCLS, why I have attended the ASCLS Annual Meeting for more than 20 years, and why I am so grateful to have all of you as part of my professional family.

Thank you for all the truly impactful work you all do for ASCLS and our profession!

Kristy Andrus, MLT(ASCP)^CM

My journey to become a licensed, certified MLT has surely been a long and rewarding one. I have been interested in the medical profession since I was a child. The difficulties and challenges I would have to overcome as a deaf person to be given a welcoming chance became ever clearer as I grew up.

While deaf people have overcome their challenges to achieve their dreams and be successful in every area of society, careers in the medical field are still largely denied to us. No matter how hard I worked, how many preparatory programs I completed, how good my grades were, or how many letters of recommendations were written by professors and others, I faced rejection after rejection. Ultimately, I was accepted into a Medical Laboratory Technology Program and received a first-class education. I became a licensed, certified MLT in December 2013, and I haven’t looked back!

I am now thriving in my career, fully accommodated and accepted in my work place. As to be expected, however, communication is not perfectly seamless. More understanding and joint effort between my colleagues and me, as well as increased awareness at the training level, would be of great benefit.

For example, though it never affects my job performance, frequent exclusion from conversation does impact me. Communication with me requires a slower pace, and often I am the last to be informed. I must wait until the conversation finishes and then eagerly ask what is going on. I remind myself that if a hearing person joined an all deaf workforce where conversation has always flowed quickly and naturally, true inclusion would require of me the same patience and effort. What would motivate me to put in that effort? First, I would need to be aware of the situation. Team dynamics and friendship would naturally take over from there.

While I acknowledge and truly appreciate sincere efforts to communicate with me, some are misguided and thus compound the issue. For example, it is commonly assumed that I am able to lip read. I am not. And exaggerated pronunciations only insist further on a language I do not speak. This is the case as well with exaggerated hand and arm gestures—simply put, a made-up language I do not understand. All these efforts are genuine but futile. More awareness is key.

Even common facial expressions can lead to misunderstandings. The issue arises when an expression does not mean the same thing in the hearing world as it does in the deaf world. For example, when receiving instructions, a deaf person may register what a hearing person understands as a frown when there is actually zero displeasure or confusion being intimated. This is not the impasse it first may seem. I can become more consciously aware of expressions I naturally make and others of the meaning they naturally assign. Together we’ve got this!

Awareness at the training level would surely inspire forward momentum. One suggestion is to offer a basic American Sign Language class in any Medical Laboratory Science Program. Another is to emphasize that workplace communication can thrive through many avenues such as email, text, video phone, etc. Perhaps ASCLS could offer a professional webinar on basic sign language and deaf awareness in the workplace. Spotlighting a deaf MLT, such as myself, also increases awareness and sparks the desire to understand more.

I am immensely proud of my career as a Medical Laboratory Technician, and my coworkers and I are a committed and passionate team. We will naturally resolve the few hurdles we now encounter with more awareness and more of what we do every day. We work together.

May every reader here truly believe that no situation or person can set limits on your potential! Never, ever, give up. It doesn’t matter how many times you fall down if the number of times you get back up is just one more. My successful career as an MLT is living proof of “just one more.”