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    Best little lab by a dam site

    April 1, 2003
    Mlo Generic Mlo Logo
    Family Doctors of Boulder City near the Hoover Dam wins the 2003 Medical Laboratory of the Year Award
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    A few miles from the grand Hoover Dam, and about 20 miles from the glitter and glamour of Las Vegas, sits Boulder City, NV. With a population of around 20,000 residents, Boulder City prides itself on a quaint, small-town atmosphere, quality recreational facilities (except gaming) and a low crime rate. Boulder City conceived by the Federal Government in 1931 during the Depression as a model city is also home to the Family Doctors of Boulder City, which by its own claim is the best little lab by a dam site. And according to MLOs three-judge panel in this years Medical Laboratory of the Year competition, it is the best little lab in the nation among the entries for 2003.Pat Armour, MT(ASCP), laboratory supervisor and the first staff member at Family Doctors to receive the news of the labs win, says, We are all very excited and proud to have been chosen as the winner of the first MLO Medical Lab of the Year Award. It is a tribute to our entire staff that you have chosen us for this award.Dr. Herve Bezard, one of the four doctors who compose Family Doctors of Boulder City, nominated his physicians office laboratory (POL) for the MLO competition. The group specializes in family practice, providing medical care and treatment for patients of all ages. Family Doctors offers an extensive set of testing services and procedures necessary for a comprehensive, preventive healthcare program on site. These include: complete X-ray, as well as mammograms and bone-density testing; treadmill; EKG; Holter monitor; spirometry; ICG; minor surgery; and of course, a complete laboratory with moderate-complexity testing.Family Doctors lab is currently staffed with one full-time technologist, one full-time assistant and one part-time technician. This staff works with the medical assistants and RNs to ensure proper sample collection, including phlebotomy assistance with difficult draws. It utilizes input from all staff to create patient information forms for example, occult blood, 24-hour urine and stool collection. The laboratory staff works with the billing department to ensure proper CPT codes are used for lab testing, researches and informs staff of Medicare Medical Necessity guidelines and monitors insurance company contacts to ensure that Family Doctors is allowed to perform on-site testing.In 2000, the laboratory underwent an expansive renovation and upgrade. Prior to that, its test results were hand-written on reports. Jumping from product to product can make it difficult to provide quality testing says Armour. Ed Boyadjian, our Fisher HealthCare sales rep, has been instrumental in enabling our lab to upgrade and move into the 21st century. He and Dennis Muchmore from Olympus America, put together an affordable package deal that allowed our lab to purchase a Olympus AU400, Criterion II and Lab DAQ LIS for less than we were spending a month on supplies and service for a 10-year-old chemistry analyzer. With its LIS interface to four analyzers, the labs efficiency, productivity and customer service were greatly improved. It is important to establish a relationship with vendors that is built on loyalty and trust. While it is true that we all have to watch the bottom line, sometimes the lowest price isnt always the best deal, Armour suggests. Established vendors like Ed are able to be on the lookout for new products, know what budget constraints I have and dont try to push products that I wont use. This makes my job easier.With the upgrades, all lab testing is performed on the same date of request, and patient results can be autofaxed to referral specialists. To further streamline productivity, patient reports can be printed cumulatively, a new test-request form was created to enhance test-ordering efficiency and a server connecting the billing system and the LIS uses the same unique patient I.D. number for a future interface with a medical-records system.Even before this major overhaul, in 1995, Family Doctors was chosen for inspection by the state of Nevada and HCFA. The lab was deemed an example of a well-run and well-organized POL, and received zero deficiencies. For future inspections, the lab enrolled in COLA. In 2000, the COLA inspector gave Family Doctors POL a 100 percent compliance rating; in 2002, it received a 98.91 percent rating. The lab has never scored below 80 percent on any CAP survey since 1990 and consistently receives 100 percent for the majority of analytes. The labs testing volume has steadily increased over the past four years, from 82,889 in 1999 to 101,090 in 2002. Family Doctors was the first lab in the Boulder City area to provide direct LDL testing, educate and provide physicians with INR results for protime, provide same-day results for Hgb Alc, microalbumin, Troponin I, and H. pylori. Current innovations include the use of the Coaguchek Protime system, with all forms created by the lab, along with staff training. HS-CRP testing will soon be available on site.Family Doctors laboratory staff has worked hard to provide high-tech service and quality patient care with the small-town personal touch. It serves the Boulder City community in ways other than merely performing patient testing, however. The staff knows many of the patients on a personal level, serving with them on school committees, attending the same churches and shopping at the local grocery store. It has also answered the needs of the educational facilities in the area.In 1993, Family Doctors responded to the flood crisis in the Midwest by sending lab equipment and supplies to a South Dakota med-tech school. After renovating its lab in 2000, an RAXT chemistry analyzer, reagents and miscellaneous equipment were donated to the Community College of Southern Nevada for use by veterinary and lab-technician students. Last year, the lab facilitated the donation of a microscope with photo capabilities to the Boulder City High School biology department. Armour speaks to numerous grade school and middle and high school classes on general laboratory testing, as well as other topics like germs, hand-washing and immunology. She has worked with advanced biology students to prepare a video on urine testing and also participated in job shadowing by local high school students. But outreach to the community involves much more than simply participating in such functions. It means that Family Doctors staff has a mutual goal and is dedicated to meeting it as a team.I think the basic premise that our staff works from is that each patient is a person and not just an I.D. number. If the staff cooperates and helps each other, then we are able to provide the best service possible to that person, she says. Sometimes that means carrying messages, helping with filing or taking the time to answer a question about a lab test. The pride the staff takes in providing quality testing and services to our patients fosters a cooperative work environment.Blessed by the gods with a good sense of humor
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    I cant tell you how excited we are! exclaims Patti Andersen, Quality Assurance Officer and nominator for MLOs first runner-up, Catskill Regional Medical Center (CRMC), Harris (Sullivan County), NY. This rural 160-bed facility rests in the heart of the world-famous Catskill Mountains, home of more than 74,000 permanent residents and triple that number in the summer. The Native American Lenape tribe first visited the area in the 1300s, and considered it blessed by the gods.A Planetree affiliate, CRMC also has a 12-bed facility in Callicoon on the Delaware River, which serves western Sullivan County and parts of northeastern Pennsylvania. After several years of staffing Callicoon on a tech-on-call basis daily for two shifts, CRMC implemented several POC instruments, trained the ED physicians to perform testing and saved $20,000 in tech-on-call expenses. Two board-certified pathologists, 12 managers/supervisors, 26 technicians, and 18 support staffers run the labs in the two facilities. Additionally, CRMC operates 13 clinics and hospital-owned physician practices, which do on-site waived testing. CRMC is responsible under JCAHO rules for these tests. After three years of training at these sites and emphasizing quality control, standard lab procedures are being achieved without a glitch. CRMC participates in New York state and CAP proficiency testing, where the lab scores 90 percent or better. Yearly, five surveys are sent out to measure satisfaction with the labs services outpatient, physician, healthcare facility, oncology draw station and employee satisfaction. Every category scores between 90 percent and 100 percent.Andersen gives kudos to the labs technology support vendors: Dade Behring and Abbott, for the i-Stat used for the POC testing, are the two vendors that have helped to make us what we are. Their representatives are always willing to work with us and take our needs into consideration, and they havent lost sight of the patient in this corporate world.CRMC offers free health screening throughout the year, and a mobile health bus to provide a draw station and mammography services for this rural community is a recent addition. CRMC is active in the Sullivan County community through United Way, the American Cancer Societys Relay for Life and the American Red Cross. At Halloween, staffers transform their conference room into Draculas Pub, where donations for food and beverages are collected. In 2001, the donations from the Pub were given to the 9/11 Fund, and last year to the CRMC Oncology Units medicine fund for patients purchase of expensive supportive prescriptions.Andersen penned her entry close to the Feb. 28 deadline. I sat down during lunch on Thursday, February 27 to read MLO. That is when I read about your contest. Most of my entry was written at work on Friday the 28th, then I finished it at home once Id fulfilled prior commitments after work. The entire staff was surprised, and they feel very honored, she says. I would have to say that we manage to work well together because of the respect and friendship we feel for each other, and the common goal of the responsibility for our patients, she says of Catskill Regionals teamwork. We are always there for each other through the highs and lows of life.A new Neighborhood in the City of Roses

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    MLOs second runner-up, Kaiser Permanente Airport Way Regional Laboratory, part of Kaiser Permanentes Health Plans of the Northwest, in Portland, OR, was nominated by Mimi Vaughan and Carol Vogt. Airport Way claims that, teamwork is the way we do business in our laboratory. Vaughan Assistant Administrative Director of Laboratories; Quality, Communication, Staff Development shares a bit of wisdom regarding the labs methods: Most of our success can be attributed to investing in strengthening relationships between labor and management, building trust and involving staff in decisions that affect their day-to-day work. Those who create tend to support.The labs old departments have been formed into Neighborhoods, with one or more teams operating under a team manager. These self-directed, high-performing teams Shared Prep, SAM (semi-automated and manual testing), Wet/Dry Microscopy and Core Lab are guided by Airport Ways Organization Social Design, which was developed through a labor-management partnership process. Each team has a Quality System Coordinator. A management-review committee examines the entire Quality System at least quarterly. More than 50 staff members participated in meetings with architects and planners to come up with highly creative and innovative features through the new laboratory. Efficiency is the significant focus of the lab, which automated the specimen-sorting line with direct no-hands feed to the HST automated hematology line, with automated slide preparation and staining (included when indicated), and to Centaur automated Immunochemistry and Stag Coag analyzers. All hematology analyzers within Airport Ways entire region are compared biweekly for correlation of results from instrument to instrument, including multiple sites and three models of analyzers. Airport Ways customer service is a high priority the Client Services Team is on duty 24×7, averaging almost 400 calls daily and answering 90 percent of these calls within a minute. The LIS Team is also on duty around the clock to provide immediate response to systems issues. Physician customers receive lab results via electronic medical record, which interfaces to the LIS. All testing in the Core Lab is resulted and recorded in the patients medical file within one hour of its receipt in the lab.The vendors that were instrumental in helping us achieve our automation goals are Lab Interlink and Roche-Sysmex, says Vaughan. The functionality created by these integrated systems has remarkably improved our service levels to our clinicians.The staff serves as a training site for MTs, MLTs, phlebotomists, histotechs and lab assistants. A high-school student program finds young people performing simple tasks, such as slide filing, specimen pick-up and delivery within the lab, and restocking supply carts.Airport Way is involved with the American Red Cross Blood Drive, the Oregon Food Bank donations, local school supplies drives, the Make-A-Wish Foundation, holiday giving projects and more.
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    This years National Medical Laboratory Week, April 20-26, is set aside to recognize and celebrate the 265,000 medical laboratory professionals and 15,000 board-certified pathologists who perform and interpret medical laboratory tests. NMLW originated in 1975 to help increase recognition for the profession of laboratory professionals, the development of which began in the 1920s.Panel of Judges Our esteemed MLO Editorial Advisory Board members who served as judges for the 2003 Medical Laboratory of the Year Award are:Leland Baskin, MD, MS, FCAP, Division Head, General Laboratory, Calgary Laboratory Services, Calgary, Alberta, Canada.Dennis J. Ernst M(ASCP), Director, Center for Phlebotomy Education Inc., Ramsey, IN.C. Anne Pontius, MBA, CLS(AMT), MT(ASCP), President of Laboratory Compliance Consultants Inc., Raleigh, NC.                                                                             
    April 2003: Vol. 35, No. 4    © 2003 Nelson Publishing, Inc. All rights reserved.