Addressing management issues

April 1, 2010

Edited by C. Anne Pontius, MBA, CMPE, MT(ASCP)

Courier qualifications

Q What are some key things to look for when hiring a
courier service? What type of training should I expect couriers to have?

A I would suggest finding a courier company that truly
understands that “the patient is our ultimate client.” In every market,
there are plenty of “Acme-type” courier companies that transport
automotive supplies, title commitments, and, as an afterthought, medical
specimens. Selecting a courier company that considers itself a “medical
specialty” courier service is critical to ensure specimen integrity.

The Occupational Safety and Health Administration
(OSHA) requires courier companies that are transporting medical
specimens to provide bloodborne pathogen (BBP) training for their
drivers upon hire and annually thereafter.

Training elements should include: 1) specimen
transportation that includes identifying risks associated with transporting
medical specimens; 2) measures to prevent exposure; 3) proper labeling; 4)
spill clean-up; 5)specimen integrity; 6) HIPAA/HITECH compliance; 7)
administrative requirements (e.g., OSHA compliant records); and 8)
definitions/language commonly used by clinical laboratory personnel in order
to better understand their needs and expectations.

OSHA also requires that courier companies receive their
BBP training from a qualified individual. “The person conducting the
training shall be knowledgeable in the subject matter covered by the
elements contained in the training program as it relates to the workplace
that the training will address.”1

Companies that train their drivers by use of a
downloadable computer program are not OSHA compliant. OSHA requires
live, real-time training that is fully interactive. “The employer must
provide an opportunity for interactive questions and answers with the person
conducting the training session.”1

Finding properly trained and qualified courier companies
can be a daunting task. But the rewards of working with someone who
considers themselves a vital part of the “circle of service” to the medical
community and to your patients are invaluable. For more information, visit  and click on “OSHA training.”

—Ken Arnold
Integrity Corporate Services
Colorado Springs, CO


  1. OSHA. Enforcement Procedures for the Occupational
    Exposure to Bloodborne Pathogens bloodborne pathogens standard.
    Accessed March 1, 2010.

A There are three areas to consider, all of which overlap
to some degree.

1. Compliance. Would the courier pass an inspection
by the College of American Pathologists (CAP) or The Joint Commission? Do
they carry regulation coolers? (Those store-bought hard plastic coolers are
not regulation, and their use could result in a fine.) Are they trained in
the hazmat aspects of specimen delivery? Do they carry dry ice or will they
require you to supply it? Since you are ultimately responsible for the
specimens being transported, you need to ensure the couriers you use are
properly trained, and re-trained at least every two years. Other
considerations include having a HIPAA business agreement in place and
ensuring proper OSHA training for bloodborne pathogens.

2. Specimen integrity. Specimen integrity is simple
but critical. Each specimen should arrive in the same condition and
temperature as it was in when picked up, with no variances in between.

3. Overall competence. All these are tied to the
competence of the courier company, which includes the courier’s on-time
rate, the number of available couriers, and the company’s experience. Ask
questions such as: How long have you been doing medical courier work? Is
medical courier service all you do? Are you open 24/7? Do you answer your
own calls, or do you use an answering service? What are the procedures for
tracking specimens? If the courier will be handling STAT deliveries, ask how
they define STAT. What are the guarantee times for different service types?
What systems are in place to verify on-time performance? These guidelines
should help you find a competent medical courier service.

—Dan Weissmann
Texmaster Express Medical Couriers
Arlington, TX

Bottom line: As the experts have pointed out, the courier becomes a business partner
with you. With the new HITECH rules for Business Associates, it is more
complex than ever to ensure you partner with a courier that takes
regulatory compliance seriously. Make sure the couriers are trained on
rules from the DOT, OSHA, and HIPAA.

Congratulations to the winner of the MLO Medical Laboratory of 2010! Kudos to all of the laboratories that submitted applications, as they deserve recognition for their innovative ways to meet the needs of patients, physicians, and staff but our winner stood out as exemplifying ways to overcome operational challenges in all areas. From teamwork to customer service and productivity to quality, our winner can be very proud of its contributions to high quality healthcare.

—C. Anne Pontius, MBA, CMPE,

president of CLMA,
Senior Medical Practice Consultant,
State Volunteer Medical
Insurance Company,
Brentwood, TN

Contact her at [email protected] .