Archive for the ‘Laboratory’ Category

The 2012 ASCP Workshops for Laboratory Professionals

Monday, May 14th, 2012

Summaries by Hopkins Pathology Employees

As part of its commitment to continuing education,  the Department of Pathology sent nearly 300 employees from Johns Hopkins Hospital, Johns Hopkins Bayview Medical Center, Howard County General Hospital, Suburban Hospital, and Sibley Memorial Hospital to the annual ASCP Workshops for Laboratory Professionals in Towson, Maryland, between May 1-4, 2012.  Some of our employees shared their reviews with us, and we are thankful for their generous time:   

Practical Hemostasis: Laboratory Aspects of Bleeding and Thrombosis

The presentation, Practical Hemostasis:  Laboratory Aspects of Bleeding and Thrombosis, was very interesting.   It covered coagulation factors such as intrinsic and extrinsic factors and the disorders associated with each.  One interesting topic was the determination of factor deficiency vs. factor inhibition, whereas factor deficiency corrects with mixing study, factor inhibition would not.   Our bodies’ ability to regulate/increase the level of Factor VIII during trauma situations would lessen the degree of bleeding.  However, postpartum patients have high risk of bleeding.   Despite the fact that they are going through a trauma situation, estrogen and progesterone interfere to inhibit Factor VIII which explains the high risk of bleeding.

Towards the end of the presentation, the importance of correct sample collection, including the serum-to-anticoagulant ratio, was discussed.  Abnormal results that are not consistent with patient results should be further investigated.

Overall, the presenter was very knowledgeable and I found it very interesting.

Yeshanew Teklie, MT(ASCP)
Clinical Laboratory Scientist III
Howard County General Hospital


I attended the workshop entitled “Practical Hemostasis:  Laboratory Aspects of Bleeding and Thrombosis.”  This workshop was very informative. Both presenters were very clear and knowledgeable about the material.  They went over the intrinsic and extrinsic pathways of the coagulation cascade, which was a nice review.   The details of Factor assays is not something I think about when running routine coagulation tests, but our presenters talked about how different factors affect the PT/PTT/TT and Fib results.   The last part of the workshop dealt with anticoagulant therapy and the effects these drugs have on the PT/INR and PTT results.  This we deal with on a daily basis.

Both presenters were open to questions, often referring to each other for clarification of the answers.

Roselyn Caslin, MT(ASCP)
Clinical Laboratory Scientist III
Johns Hopkins Hospital


The workshop “Practical Hemostasis: Laboratory Aspects of Bleeding and Thrombosis” was very informative and provided in-depth review on hemostasis.  It covered both coagulation and fibrinolysis systems and tests for evaluation of bleeding and clotting disorders. The speakers,  Dorothy M. Adcock-Funk, M.D., and J. Michael Taylor, M.S., gave a brief review on activated partial thromboplastin time and prothrombin time assays and how to evaluate abnormal results.  They also discussed the focus on cost-effectiveness; how to monitor anticoagulant therapy and how newer anticoagulants interfere with hemostasis assay.  Overall, this workshop really helped me understand the laboratory aspects of hemostasis.  I highly recommend this workshop to anyone who wants to learn more about hemostasis.

Farhan Ahmad
Clinical Laboratory Scientist II
Flow Cytometry Laboratory
The Johns Hopkins Hospital


The Art of Phlebotomy

The Art of Phlebotomy workshop, given by Marilyn Singleton McCain, was very informative.  Although I have been drawing blood for over 20 years, there was so much new material presented that will help me to improve my phlebotomy knowledge and skills.  We learned about the latest OSHA, CLSI, and NAACLS regulations and guidelines regarding patient and personal safety when performing phlebotomy and about the newest safety devices, as well as bloodborne pathogens, legal and risk management updates, how to improve customer service and communication, and how to improve venipuntures.  As an example, I learned that a certain place on the inner arm has many nerves which will become damaged if a patient is stuck there multiple times over a course of years, and so that is it important to avoid that area.

To summarize, I believe this was an excellent workshop and I highly recommend it to other phlebotomists or those who perform phlebotomy on a regular basis.  Ms. Singleton McCain was a dynamic speaker who taught me a great deal.

Sherrie Hicks-Rose
Certified Phlebotomist/Lab Technician
Core Laboratory
Johns Hopkins Hospital

The ASCP’s “Art of Phlebotomy Workshop” was very interesting and helpful, particularly the time devoted to documentation. Our presenter, Marilyn Singleton McCain, stressed how important proper documentation is in the phlebotomy field. Documentation is used as a tool to help determine answers to specific questions about a patient’s blood draw. Certain guidelines must be followed when documenting. Always documenting in ink insures that information cannot be changed or erased. Recording a patient’s name insures correct patient identity. Recording date and time of each collection fortifies the collection of all specimens. Using medical terminology is a concise method which helps to avoid any confusion for written narratives or lingo. Drawing a line through mistakes with initials allows us to visibly see a mistake without appearing as a cover up. Documenting all adverse occurrences is important, e.g., patient refused blood draw, difficult draw, patient experienced syncope, etc. Documentation can be legally binding and, therefore, you should never document or sign-off for anyone else.

These few but very important steps give clear, concise, and legal information that answers questions to any additional issues concerning a patient.

Lennoria Joseph
Laboratory Phlebotomist
Johns Hopkins Bayview Medical Center


Passing Inspections:  Practical Game Plans and Proven Strategies
Improving Quality:  QC is More than Statistics!

Passing Inspections:  Practical Game Plans and Proven Strategies

Looking ahead to non-waived testing, EQC (Electronic Quality Control) will be replaced by EP23 in 2-4 years, by 2016 at the latest.   EQC refers to the manufacturer’s approach to QC — electronic, procedural, built-in liquid that differs from CLIA Gold Standard External Liquid QC.   EP23 refers to hospital-based lab evaluation protocols that we establish.  Competency is an especially hot item this year. A more detailed and creative measure of each employee’s skills is required. Some of you may have already experienced this in preparation for your upcoming evaluation. This competency revision includes: direct observation of patient testing from the beginning of the test protocol, entering the final result, answering questions asked by the lead involving problem solving, observing instrument maintenance performance and troubleshooting skills.   There is nothing new on the horizon for waived testing other than following the manufacturer’s directions.   We rarely, if ever, get loaner instruments.  However, if we do, we need to treat them like a new instrument. That means you must establish QC for any loaner instrument.

Improving Quality: QC is More than Statistics!

This QC workshop was elaborate in covering the many factors involved in defining good QC.  I will briefly discuss several of topics that I can relate to in my work.  Patient safety is one of them and it can be enhanced through Quality — meaning right vs. wrong.  Risk management is necessary to ensure quality through all phases of the patient testing process.

As professionals, we can all play a role throughout this process beginning with the preanalytical phase and ending with the post analytical phase.  We can catch potential errors prior to them becoming risks that affect patient safety. Risk management and QC are essential for Analytical Quality (Regulations, Proficiency Testing, Six Sigma, CAP Inspection, etc.).  For more information about patient safety, AACC offers a free monthly newsletter on patient safety at

It is also helpful to know what Jim Westgard’s rules really mean as they relate to QC. It is more than statistics. It is about random error vs. systematic error. This matters in how you would respond to correcting the error. For example, R4s rule is a random error. In this case you would rerun the sample.  This could be caused by bubbles in reagents and reagent lines, testing personnel variation, or other things.  In contrast, 41s rule is a systematic error. Repeating the sample or opening a new vial is not the solution. Further investigation is required due to an internal cause, e.g., pipettor misalignment, reagent issues, change of lot numbers, and other causes.  For more information, there is a free website, but you must register,  and click-on Multirule Interpretation.

Bette Ford, MLT (ASCP)
Lead Clinical Laboratory Scientist
Hematology Laboratory
Johns Hopkins Hospital


Improving Quality: QC is More Than Statistics!

Each Spring I anxiously wait for the ASCP Workshops flyer to arrive. I know that in addition to the valuable technical knowledge available, there is another less tangible benefit: that sense of refreshment and renewal that comes from gathering with the wider community of colleagues to look at new topics and not-so-new topics from a new or different perspective. Sometimes there is validation for our current stance or practice; sometimes there is a way to fine-tune something we are doing. Sometimes there is a new way to relook at something we have been doing for a long time.

For me, there was a little of each of those in the “Improving Quality: QC is More Than Statistics!” session. Sharon Ehrmeyer, who heads the MT/CLS program at the University of Wisconsin, is a vibrant and enthusiastic speaker with a lively sense of humor. In a session which seemed far shorter than the clock on the wall showed, Dr. Ehrmeyer reminded us of just why Quality is spelled with a capital Q for laboratorians, how intimately the quality of our laboratory testing is related to patient safety, and just how useful the term “risk” is in thinking about our whole testing design. As Dr. Ehrmeyer stated, “Realize, we are always involved in Risk Management!”

Moving from the ethical and theoretical bases to the legalities, we reviewed the CLIA regulations, highlighting those with more specific statements and requirements for quality control, in particular, the so-called “Gold Standard” of two levels of QC at least once each day for patient testing. The CLIA definition of EQC opened a portion of the presentation devoted to the evolving nature and role of EQC (not electronic but equivalent QC), evaluation strategies, and shortcomings of EQC, and the interrelation of risk management, EQC, more traditional QC schemes and the Quality Control Plans which are a part of CLSI EP23.

No QC presentation would be complete without a review of the Westgard Rules, including a discussion of types of errors, and appropriate selection of the rules to monitor different types of error. However, Dr. Ehrmeyer went beyond a simple review into some depth with respect to selecting and implementing the right QC, using a formalized QC selection process, and using additional tools such as the OPSpecs Chart and Six Sigma Metrics to develop the right QC for each test.

The final slide of the presentation gave a very neat summarization of the huge amount and range of information covered, in five simple statements:

  1. DO define quality required for each test.
  2. DO select QC procedures to minimize false rejections.
  3. DO select QC procedures to detect medically important errors for each test method.
  4. DO adopt modern QC planning tools.
  5. DO standardize QC operations. (

A whole session of QC could seem like a fearfully dry, humorless session, but the morning with Dr. Ehrmeyer was anything but dull, definitely not humorless, and worth every minute spent there. I am so glad I was able to attend.

Edith Burns, MT(ASCP)
Clinical Laboratory Scientist III
Point-of-Care Testing
Johns Hopkins Bayview Medical Center


It was a great privilege to attend the two half-day workshops presented by Sharon Ehrmeyer, Ph.D. on May 1.  Both workshops touched on CLSI’s new EP23, Laboratory Quality Control Based on Risk Management, and the relationship between quality laboratory testing, CLIA regulations, and CAP and Joint Commission standards.

Improving Quality:  QC is More Than Statistics!

During the morning session Dr. Ehrmeyer stressed how to make good choices to find the best QC material and process for each particular laboratory test.  She introduced the topic by relating quality laboratory testing to The Joint Commission’s Patient Safety Goals and, therefore, to hospital Risk Management.   She then explained how to use Westgard’s analytical quality framework to develop the best QC process for each laboratory test.

She also clarified how the concept of Equivalent QC fits into this quality framework from both CLIA and CAP perspectives.  She then demonstrated QC rule selection using Westgard OPSpecs charting (OPSpecs is Operational Process Specifications).  Dr. Ehrmeyer proceeded to show how the Six Sigma process can also be presented using the Westgard QC rules and the OPSpecs QC selection tool.  Finally, she did a review, using Risk Management to help choose the correct QC for the method

Passing Inspections: Practical Game Plans and Proven Strategies

The afternoon session stressed approaches to attain all the CAP or Joint Commission laboratory accreditation standards and how to prepare for an inspection, especially by performing self-inspections. Dr. Ehrmeyer explain in great detail the relationships between CLIA regulations and The Joint Commission and CAP standards, the deemed status, and the rationale behind CLIA regulations and CAP standards.  She had detailed hints directly from CMS Director of the Division of Laboratories, Judy Yost, on how to meet specific CLIA regulations.

Dr. Ehrmeyer’s talk also included a large section on Waived Testing and Point-of-Care Testing, including the definition of Equivalent QC (EQC) and how to demonstrate the equivalency of EQC.  She concluded her talk with a review of Competency Assessment and a reminder that we should continually strive for the Right Test, on the Right Patient, and the Right Specimen collected at the Right Time, with the Right “Handling” to give the Right Result, and deliver it to the Right Patient Record.

Judy A. Horton, DA, MS, MT(ASCP)
Laboratory Point-of-Care Coordinator
Suburban Hospital


The Chemistry “Markers” of Disease

I attended the ASCP workshop “The Chemistry Markers of Disease” on May 2nd.  The workshop was very informative, it was a good review of my prior knowledge and I learned about some testing that I have not personally performed before.  The instructor was very informative and kept the class interesting and engaging. The workshops in general are very organized and helpful.

Nicole Carroll, H(ASCP)
Clinical Laboratory Scientist III
Johns Hopkins Bayview Medical Center


The workshop, “The Chemistry Markers of Disease,” was presented by Lorraine Doucette, MLS (ASCP).   Ms. Doucette spent the morning session describing the cardiac markers that are used to diagnose Coronary Artery Disease (CAD) and Congestive Heart Failure (CHF).  She explained the pathology of CAD, the role of cholesterol in plaque formation, and the effects of diet and exercise on coronary health.  Unfortunately, a large part of the talk was spent on the pathology of disease and even the social and political ramifications of healthcare management, rather than focusing on the laboratory medicine that might have been of more interest to the laboratorians in the audience. The second half of morning session focused on bone metabolism and disease and the chemistry markers used in following bone health.  Ms. Doucette also discussed the endocrine functions of the kidneys and described how various chemistry parameters are affected by different diseases of the kidneys.  She gave a brief overview of endocrine function, describing the protein hormones and the steroid hormones, as well as the regulation of hormone secretion and some diseases of the endocrine system. The afternoon session included a discussion of liver diseases and liver enzymes, followed by discussion on various types of cancer and the use of tumor markers for diagnosis and treatment.  She also covered various types of enzymes and hormones and their roles in various types of diseases, as well as a brief discussion of serum proteins and carcinoma-associated antigens.

The day-long presentation was a good review of basic physiology and general chemistry.  Much of the talk focused on the pathology of diseases and even treatment of the diseases.  Although it provided a good overview, most of the discussion was very basic.  I personally would have liked more detailed discussion of current trends in laboratory medicine and challenges faced in the chemistry lab.  I suspect that most experienced medical technologists, especially experienced chemists, and might find the information in this presentation too basic.  The slide set provides an excellent review of chemistry, however, and it will be useful in the future to use as a reference and as a teaching tool for students, new MTs, or techs that have been away from the chemistry lab for a long time.

Anne Sholander, MT(ASCP)
Sr. International QA/QC Coordinator
Dept. of Pathology, SMILE


Is it Reactive or Malignant? Enhancing Diagnostic Skills in Morphologic Hematology

Ms. Jill Smith’s presentation, “Is It Reactive or Malignant? Enhancing Diagnostic Skills in Morphologic Hematology” was both informative and thought-provoking.  The material covered many of the morphologic features that can aid in the diagnosis of a hematology or oncology patient.  In the Hematology Laboratory located within the main Core Laboratory, we routinely see “reactive” lymphocytes as well as malignant cells so this part of the presentation was basically an overview.

The pieces of the presentation that I found thought-provoking were other techniques that laboratories perform that we don’t necessarily carry out, such as scanning the feathered edge of the slide for an indication of what we may see in the smear.   In my opinion, this technique could go either way — it could help someone find any otherwise absent Microfilaria, as in Ms. Smith’s example, or it could confuse a less experienced technologist.  Another concept I was introduced to was the vortexing of specimens to get rid of platelet clumps.  Although I found this to be extreme, it was an enlightening piece of this lecture.

I also enjoyed the review of the many types of morphologic changes that one may see in particular disease states and malignancies.  Though we may differentiate these into much broader categories such as “prolymphocyte,” “blast,” or “young unidentified” cells, it was a great review of all the particular types of cells we often see.

What I like most about workshops such as these are discovering other techniques laboratories around the nation employ compared to what we do at Hopkins.   Sometimes we tend to forget that our way is not always the best way, or maybe we are reminded of why we do things the way we do.

Holly A. White, MT(ASCP)CM, MSHS
Clinical Laboratory Scientist III
Johns Hopkins Hospital
Research Program Assistant II
Johns Hopkins Bloomberg School of Public Health


I went to the Hematology session, “Is It Reactive or Malignant:  Enhancing Diagnostic Skills in Morphologic Hematology.”  The session was informative and the presenter was very knowledgeable.  In a session like this, you have plenty of examples to get a viewable understanding of the subject.  Jill Smith gave the 100+ attendees plenty to view and good explanations, as well as personal insights.  The subjects reinforced some of my personal knowledge and updated me on the newer methodologies of diagnostic hematology.   There are new molecular tests that can be used for such diseases as lymphomas and myeloid leukemias.   Always keep in mind, however, that a good tech can see new cases on a simple blood smear.  You may see blasts or megakaryocytes or that lymph that “just doesn’t look right.”  That’s when you KNOW you have made a difference.  That’s a discovery.

John T. Hargrove, MT(ASCP)
Coordinator of Client Services, Clinical Laboratories
Johns Hopkins Bayview Medical Laboratories
NPR Report Writer


Quality Management Systems – Transitioning for the Future

Ruth Biehl and Chloe Scott took us through the Quality System Essentials in relation to ISO 15189 Guidelines.  The presentation was a great review to be certain we are up to standards with our own Quality System.   A group exercise provided hands-on practice in applying the essential element concepts.  Ruth and Chloe had us work through the system essentials to teach a three-year-old child how to make a peanut butter and jelly sandwich.   We took each essential in order, beginning with Organization all went the way through Purchasing and Inventory.  It was a fun and functional exercise that required you use your understanding of each system element.

Patricia Wachter, M.A., CT/HT(ASCP)
Quality Assurance Specialist
Continuous Quality Improvement
Johns Hopkins Hospital


I attended the “Quality Management Systems – Transitioning for the Future” workshop at the 2012 ASCP Conference. It was an informative workshop that gave us the tools to go back to our own lab and assure that our Quality Management System was meeting standards.  I came back with some recommendations for the Immunology Division on how to improve our quality systems.  We learned the “10 Basic Elements of Quality.”  One that interested me the most in the discussion was Step 10:  Continual Improvement.  An integral part of improvement in any lab is to be Pro-active, not Reactive.  When there tends to be a number of problems or errors, it is easy to blame staff on these errors, but the problem may be in the process or procedure.  When techs continue to make the same problems, it is imperative to determine the root cause.  Then when you find the cause, you select and implement a solution to prevent the re-occurrence!  Overall, I was pleased with the information that I received.  The instructors were very knowledgeable knowledgeable and pleasant.

Cathy Smith, MT(ASCP)
Clinical Laboratory Scientist III
Immunology Lab
Johns Hopkins Hospital


This year at the ASCP Workshop I learned the essential elements of a Quality Management System (QMS). Not only am I more aware of the impact of a well-established QMS in a medical laboratory, I now have the knowledge and skills needed to evaluate and teach others about the best ways to maintain quality in the Transfusion Medicine Division.   The QMS guidelines allow Clinical Laboratory Scientists to perform a better job in contributing to the best healthcare possible for patients at Johns Hopkins Hospital.

Alissa Arellano, MT(ASCP)
Clinical Laboratory Scientist
Transfusion Medicine Division
Johns Hopkins Hospital


I really enjoyed the workshop, Quality Management Systems Transitioning for the Future.  Quality Management is a fairly new topic, and I always wanted to have a better understanding of this aspect in the laboratory setting.  The speakers were knowledgeable and presented the content well.  The ten elements of quality management (ISO 15189) were explained and discussed in detail, and our speakers facilitated the Q & A session to ensure that everyone was at ease with the topic.  Then we all had to participate in small groups in hands-on practice to teach a three-year-old how to make a peanut butter and jelly sandwich from scratch, incorporating all basic elements of quality essentials!   As you can imagine, this exercise was fun and informative.  The speakers had an engaging approach and promoted interaction among the learners.   In my opinion, this workshop was definitely educational and valuable.

Sudi Soleimanpour, MT(ASCP)
Laboratory Supervisor, Technical Operations
Johns Hopkins Laboratories/Zone 1


 Become an Innovative Leader in Healthcare Today

Maria Brock and Karen Tilstra taught us how to be creative problem solvers and innovative thinkers.  We were introduced to the five steps of Design Thinking:   Empathize, Define, Ideate, Prototype, and Test.  The concept of empathy was enlightening.  I had been accustomed to the concept of voice of the customer (VOC), and somehow the word “empathy” carries a deeper meaning for me.  It was defined as “no solutions until you experience what the end user experiences.”  Rather than just listening to the problem, I must relate somehow to what is going on with the customer.  The definition of the problem arises out of the empathy.  Maria and Karen also talked about FeedForward as an alternative to Feedback.  The insight that comes from these comments is critical to moving the project forward.  They introduced yet another new concept of “Yes, and….,” in place of “No, but ….”  We can tell team members “Yes, that is a great idea and …..”  We are now acknowledging the thought process and giving credence to the effort, not shooting ideas down with a “No, but ….” 

Words are a very powerful weapon…. use them wisely.

Patricia Wachter, M.A., CT/HT(ASCP)
Q.A. Specialist
Continuous Quality Improvement
Johns Hopkins Hospital


Creative problem-solving is something that we all use daily, especially in Outreach, so I was excited to discover that ASCP was offering a workshop dedicated to this essential skill. All in all, the workshop was fun and somewhat informative, however, I think it lacked cohesiveness at times, and the concepts and objectives weren’t always very clear or understandable. To be quite honest, the length of the workshop could have been shortened, too. We participated in various “hands on” projects to emphasize the concepts of innovation and problem solving. We tried our hand at Ebru, a Turkish art technique that floats paint on water (also called paper marbling). We were told to create three paintings. Of course, the first painting turned out horribly because you wanted to get it finished in a hurry, and since it was the first time there were some mistakes made and some experimentation with the process. The second painting was better, but the third was “a masterpiece.”  The purpose of this exercise was to demonstrate how to prototype, evolve and improve when problem-solving. Usually your first design or step in problem solving is crude, but  as you progress through the steps, you eventually (hopefully) get to a desired endpoint after trial and error and understanding the steps along the way.

Bill Hartlove, MT(ASCP)
Lab Manager, Pathology Outreach
Department of Pathology
Johns Hopkins Medical Institutions


I really enjoyed the ASCP workshop on being an Innovative Leader in the Laboratory. The motto of the workshop was “Yes, and ….” instead of “No, but ….” It was not the normal setting of just sitting and listening. The interaction was great.  We use the tool of listening (feedback) and responding with “Thank You” only.   Good, bad, happy, or sad, I will work on becoming a better listener to improve the culture to shape Suburban Laboratory into a world-class laboratory.

Tabitha L. Little Baker, H(ASCP)CM
Hematology Specialist
Suburban Hospital


“Become an Innovative Leader” was by far the best and most interactive ASCP workshop that I have ever attended.  The room was set up with many round tables where we sat amongst our peers in a group setting.  The workshop was led by a group of employees with many different backgrounds from Florida Hospital who were all part of their Innovation Team.  They directed our group in many activities that forced us to think creatively through brainstorming and “empathy thinking.”  We were forced to go outside of our comfort zone to solve problems.  By nature, MTs tend to be very introverted but it is important to look past this to be strong leaders in our work place.  We were all challenged to come up with a problem that is common in the lab.  Our group came up with the problem of mislabeled/unlabelled specimens.  We were then challenged to go outside the lab and interview people from other professions to find out how they may solve a similar problem.  This was difficult because on the surface this issue seems to only be unique to the laboratory setting but after brainstorming we came up with a few good ideas.  We talked to valet parkers at the mall to discuss how they might identify cars when drivers have lost their tickets.  We also interviewed an employee at the hotel to find out what their procedure is for identifying guests.  This activity forced us think outside of the box to help us come up with new solutions to a common problem.  When there is a problem in the lab, sometimes the best solution might come from other areas of the hospital.  After lots of brainstorming, our group came up with a device to help eliminate this issue.  Unfortunately, this was just a one-day workshop but if it had been longer I’m confident that our team could have continued to work on our project and perfect our idea much like the Florida Hospital Innovation Team does!

Katie Bratt, M.A., MT(ASCP)
Clinical Laboratory Scientist III
Flow Cytometry Lab
Johns Hopkins Hospital


Innovative Leadership workshop was by far the most creative, engaging and useful workshop that I have ever attended at ASCP!   Thanks to JHM for giving all of us at Suburban the opportunity to attend!!

Deborah Williams, MT(ASCP)
Laboratory QA Coordinator
Suburban Hospital


Our workshop entitled “Become an Innovative Leader in Healthcare Today” was far from an ordinary meeting.  The day included how to think outside of the box, how to take into account how others feel about their job, innovative problem-solving, and even making art and a Play-Doh zoo with fellow employees.  The presenters use a team approach to solving problems in their laboratory and hospital by including various positions in the problem-solving process.  They even remove their badges in meetings so everyone can feel like an equal.  Overall, it was a good meeting and demonstrated how thinking outside of the box and collaborating with others on an equal playing field can lead to better problem solving and better patient care.

Brandon Ellis, MLS(ASCP)CM
Lead Clinical Laboratory Scientist
Microbiology Division
Johns Hopkins Hospital


The workshop’s objectives included applying design thinking, effectively seeking information to define and devise resolutions, loops in prototype and rapid feedback to creating effective solutions in the healthcare environment. The exercises were interactive allowing the participants to learn from one another; while saying “Thank you” along with “Yes, and…”  Leaders were encouraged to keep an open mind, an open heart, and an open will. Consequently, minimizing judgment, cynicism and eliminating fear leads to a culture without barriers and promotes   creativity. The leaders were in groups practicing “SOVO.”  The SOVO- Starter Statement (How might … ?) define problem from empathy, Owner (who is the owner[s]), Verb (creating positive thinking), and Objective (goal).  Each group defined a problem, assigned an owner, ideated (brainstorm), and analyzed whether the objective was met by providing feedback among the groups.  Testing the prototype and rapid feedback are key to innovative leadership, tweaking and moving on to the next problem, while learning from our successes as well as our failures.

Arneal Crocker, MSc
Department Manager, Transfusion Medicine
Suburban Hospital


Updates in Laboratory Medicine: Core Topics for CMP

I attended the CMP workshop, mainly to fulfill various lab discipline credits needed, but all the speakers were motivated, energized and made the workshop interesting and enjoyable. Not having been in Blood Bank or Micro for many years, yet the lectures were informative and understandable.  Being more geared in Heme, I especially enjoyed the first one with different blasts, reactive cells, and patient history. What did I take away from this?   I saw a micro filaria on a slide, when there are fragile cells in a smear, remake the smear using 20% albumin, better ways of utilizing platelet transfusions, and much, much more.  Bottom line, if there is something you can do to help a patient’s diagnosis or recovery, do it!

Shirley Fuller, CLS (ASCP)(CSMLS)
Lab Specialist, Flow Cytometry Lab
Johns Hopkins Hospital


I attended the course, Updates in Laboratory Medicine: Core Topics for CMP, at the ASCP Workshop on May 3.  It was great to have five different lecturers who shared their expertise on the following topics:  Clinical Hematology Cases; The Laboratory’s Role in Diagnosing, Treatment, and Prevention of Obesity in the U.S; Microbiology 2012: Look to the Past and Find the Future; and Current Trends in Platelet Transfusions.

The lecture on obesity was the one that impacted me most.  The projection is that by 2030 over 50% of Americans over 20 will be OBESE, not just overweight!  The lecture also taught the participants about the health consequences of obesity in regard to coronary artery disease, diabetes, childbirth complications, renal, liver, gall bladder, bone, joint and urinary disease. We were encouraged to eat healthy and be healthy.

For someone like me who requires CMP for my certification, this workshop is a boon to be updated and educated, and at the same time fulfills my ASCP requirements.  Thank you, Johns Hopkins, for giving me the opportunity to attend!

Cyrene Abcede, M(ASCP)CM
Transfusion Medicine Division
Johns Hopkins Hospital


Body Fluids: a Practical Approach

Body Fluids, A Practical Approach was an excellent, very informative seminar. The slides we received will serve as an excellent tool for in-service education.  The presenter of the Body Fluids workshop, Leilani Collins, Associate Professor, University of Tennessee Health Science Center in Memphis, was concise and explained the topic and concepts with clarity and ease.

Santiago Saez
Medical Technologist
Sibley Memorial Hospital


The ASCP body fluids workshop was presented by Leilani Collins, who is associate professor at the University of Tennessee Health Science Center, Memphis, TN.   The presenter reviewed identification of cells in cerebrospinal fluid (CSF), serous (pericardial, pleural, peritoneal, ascitic) fluid and synovial fluids.  Images of normal and abnormal, benign and malignant cells in each type of fluid and the significant crystals occurring in synovial fluid were included.

A brief presentation of findings in bronchoalveolar lavage specimen was also incorporated.  I learned that ciliated epithelial cells may be more easily identified in the counting chamber since they appear as moving cells. These cells indicate that the specimen was not collected in the right part of the lung.

The workshop had a very practical approach.  The handling of the various types of fluids (e.g., BAL containers should be open under biological hood), the specimen requirements, the preparation of the cytospin slides, and the QC were discussed.  The questions at the end of the workshop led to a stimulating discussion.  The workshop was a good review and will help me in my teaching CLS students and new employees.

Esther Lipsky, MT(ASCP)
Clinical Laboratory Scientist IV
Johns Hopkins Hospital


Get LEAN in the Laboratory

I attended the ASCP workshop, “Get Lean in the Laboratory”.   It was presented by Karen Young who was a most enjoyable and enthusiastic speaker.  I left there with several tools that I will be using to look for redundancies in order to streamline some processes.  Ms. Young emphasized the importance of getting input from the staff who are the end user for our internal processes. She divided us into six teams and we did several interactive exercises to demonstrate her points.  The whole room really enjoyed this, and we all walked away with more knowledge than when we came.  I was one of four lucky ones who won Driving Operational Excellence, a book in which she authored Chapter 13.

In all, this was one of the best seminars I have ever attended.  I want to thank JHHS for the opportunity and to let them know that was indeed money well spent.

Marie Moninger, MT(ASCP)
Core Lab Supervisor

Suburban Hospital


Blood Bank: Optimizing Your Role in Transfusion Safety

Assistant Professor Michelle Brown of the University of Alabama presented this Blood Bank workshop in an effort to educate participants on the importance of  transfusion safety.  The workshop began with an evaluation of blood utilization practices, moved into the analysis of serological and clinical case studies, in addition to transfusion reactions, error reporting, and antibody workups. The lecture touched on all areas of the Blood Banking spectrum, and with a few stories of transfusions-gone-wrong thrown in the mix, proved to be both informative and entertaining.

Krystina Patterson, MT(ASCP)
Clinical Laboratory Scientist
Division of Transfusion Medicine
Johns Hopkins Hospital


After the first successful human-to-human blood transfusion in1818, transfusions became an integral part of lifesaving procedures.  Today, one unit is transfused every two seconds and transfusion safety has become the highest priority.  The focus on decreasing the risk of disease transmission during transfusion was pushed to the forefront by the public after the introduction of AIDS in the 1980s.  Today donors are screened thoroughly before donation by undergoing a physical exam and a donor history examination.  After the donation, samples of the blood are tested for Hepatitis, HIV 1 and II, West Nile, Syphilis, CMV, and antibody to T. cruzi.  Patients are screened and possible antibodies are identified, when feasible, before transfusion of blood products to provide low-risk transfusions.  The FDA currently monitors all Blood Banks with special emphasis on any transfusion reactions that occur.  Blood utilization committees, whose members comprise a variety of sources, were also put in place as well for peer review of transfusions.   Transfusion audits are performed on all units, to watch the transfusion process from start to finish.  This audit is usually done by members of the blood bank.  Transfusion safety is the top priority to ensure patient safety standards are being met.

Caitlin Kelly, B.S., MLS(ASCP)CM
Clinical Laboratory Scientist III
Transfusion Medicine Division
Johns Hopkins Hospital


On Friday May 4, I attended the Blood Banking ASCP conference on Optimizing Your Role in Transfusion Safety. As a current blood banker and SBB student here at Hopkins, I was not sure if the lecture would be geared more toward those with very little blood banking experience, covering the basics, or if it would be more advanced.  I was very impressed to see that the lecture given by Michelle Brown was given in such a way that no matter your blood banking background, there was an opportunity to learn about both basic and advanced topics by reviewing various blood bank policies, processes, and procedures, and by going through case studies. She also allowed the audience to discuss, share opinions, and give different ideas on current variations in processes and topics. I learned a lot during the conference not only from Michelle but from those attending that were willing to share and give ideas. Overall, I think this was an excellent lecture to attend, no matter if you worked in a Chemistry lab and were attending to keep up on continuing education or were an SBB looking for a good review in important blood banking issues.

Heather Smith, MLS(ASCP)
Clinical Laboratory Scientist III, SBB Student
Transfusion Medicine Division
Johns Hopkins Hospital


The conference I attended was very informative and interesting.  Two areas covered that were highlights for me were blood utilization and laboratory diplomacy.  The workshop included valid ideas, methods, and examples for maximizing usage of our limited blood resources by getting hospitals (i.e., doctors) to minimize their transfusion orders to better suit actual patient needs.  There was also a good discussion on improving the poor lab-doctor-nurse relationships often seen in hospitals which have a very negative impact on patient care and employee satisfaction.

Victoria Humenik
Lead Medical Technologist
Transfusion Medicine Division
Johns Hopkins Hospital


I attend the ASCP conference, Blood Bank: Optimizing Your Role in Transfusion Safety.  The conference was a great resource which can help me in my everyday work setting.  The conference had a very knowledgeable speaker, Michelle Brown. She had an excellent presentation planned such as reading panels of mixed antibodies.  I hope to use all the knowledge that I got at the conference every day at work.

Thank you for such a great resource.

Keya Dalal, M.S.
Medical Technologist
Transfusion Medicine
Suburban Hospital


The Blood Bank seminar was very good.   The speaker, Michelle Brown, was a very excellent presenter. She gave us a lot of helpful tips and suggestions which are very helpful for Blood Bank techs.  As an example, she suggested that a person from the Blood Bank should follow a unit for patient transfusion to the floor, then observe if the nurses are following the SOP for transfusion.   It would be very good practice for patient care.

I learned a lot from the workshop and am thankful that I was able to attend.

Violeta Z. Moncada, MT
Blood Bank
Sibley Memorial Hospital

One of the key points our speaker, Mrs. Brown, mentioned was the need to educate physicians on how to reduce the number of unnecessary cross-matches ordered on patients, for instance, low Hct/Hgb does not always mean the patient needs a blood transfusion unless it is accompanied by underlining disease, trauma, or surgery. Transfusion reactions and antibody introductions (caused by transfusion) could be avoided if other options are used to correct the problem prior to blood transfusion.

Almaz Asgedom
Medical Technologist
Sibley Hospital