Laboratory network serves the healthcare needs of millions in northwest Indiana

June 22, 2017
Sam Terese President and CEO,PCL Alverno Clinical Laboratories


I have been President and CEO at Alverno for the past five years. Prior to this, I was COO and VP of Hospital Operations. Prior to joining Alverno, I was the laboratory director at Elmhurst Memorial Hospital in Illinois.

MBA, University of Illinois at Chicago; BS, Medical Technology, Rosalind Franklin University, Chicago; BS, Biology, the State University of New York at Buffalo.

Spending time with my family is what I enjoy the most. All three of our children are grown and two are married, so being able to spend a family vacation brings me the most joy in my personal life and maybe a round of golf or two. I am also actively involved in many laboratory conferences, and present on our lab model in the United States and around the world. Locally, I am involved in the Society of Innovators, created by Ivy Tech Community College Northwest. The society is very focused on advancing the northwest Indiana community.

If you were explaining PCL Alverno to someone who is not familiar with it, how would you describe its main components? PCL Alverno is the reference laboratory of an integrated laboratory network for two healthcare systems, Franciscan Health and Presence Health. The hospital laboratories perform all time-dependent, or STAT, testing on site, but testing that is not critical to diagnosing life-threatening illnesses, or is more esoteric in nature, is sent to PCL Alverno through a network of couriers to process those specimens. We have specific turnaround time standards established so the physicians who order testing at the hospitals know when the test results will be available to ensure the best patient care possible.

Simply as a matter of definition, what is a “laboratory network”? A laboratory network consists of an interconnected group of laboratories. For PCL Alverno, it is our large-scale reference laboratory in Hammond, IN, which serves its parent healthcare systems along with being the reference lab for other hospital laboratories, clinics, and physician offices. Our network includes many patient service centers and in-office phlebotomy staff.

What are the benefits of the consolidation of laboratory services? The most obvious benefit is lower cost through economy of scale. The other benefit, which may not be so obvious, is that the large volume of specimens allows us to invest in advanced technology. When used correctly, that technology has the power to truly improve outcomes for patients and, in fact, may save lives.

Automation is very expensive, but if a system orders multiple pieces of equipment, pricing is much more advantageous. In one instance, we purchased more than 140 instruments and four automated lines and installed all in a six-month time span, allowing us to achieve a significant level of standardization. Our relationship with our vendors—we prefer to think of them as “partners”—and our size as a system allow us to make such amazing purchases. PCL Alverno also has invested in microbiology automation, including the Wasp, WaspLab, multiple MALDI-TOF instruments, and Microscans. We use LCMS extensively in Chemistry as well as multiple automated lines. We are also able to use digital pathology to connect our hospital pathologists with our central laboratory.

What major laboratory services are provided by PCL Alverno’s central lab? PCL Alverno provides testing in just about all technology service lines, from simple chemistry testing to hematology, microbiology, infectious disease testing, flow cytometry, molecular biology, and anatomic pathology. Through our logistics partner we make almost 400,000 pickups each year.

PCL Alverno is an ISO 15189-accredited laboratory. What does this mean to network members and the patients they serve? The ISO certification shows our commitment to quality. It goes above the required certifications for laboratories, for a deeper dive into processes and how we perform laboratory services and our commitment to continued improvement. It helps us move away from the usual laboratory “reaction” to issues to being proactive in finding and eliminating the issues before they appear.

Another set of tools we use are those that were shared with us by Danaher Business Systems. Our partnership with Beckman Coulter has given us access to these most valuable tools, and we have built a Department of Quality around these teachings. We call ours “Alverno Business Systems,” in which our quality team educates our leaders and staff on daily management, Kaizen, Gemba, LEAN—all designed to be proactive.

As the network grew, standardization of infrastructure, including LISs, must have become increasingly important. How has PCL Alverno partnered with vendors to accomplish that? When managing nearly thirty laboratories, with multiple laboratory information systems, multiple databases within each, and outreach clients, standardization is a great tool to lessen the complexity of the system. We have teamed with PolicyStat to standardize our policies and procedures; this can be accomplished when all laboratories use the same equipment. We choose not to change the LIS systems that are used in the multitude of sites. We have successfully created interfaces and middleware to allow the integration model to work.

Can you tell MLO’s readers something about PCL Alverno’s history and its growth over the years? In the early 1990s, Dr. Robert McBride, a pathologist, had a vision of what was needed in response to the changing demand of the marketplace and to increase laboratory efficiency and adaptability in an ever more complex world of diminishing reimbursements. His vision is what began the journey of PCL Alverno and the formation of the network. In 2005, this vision was furthered by forming a joint venture between the Sisters of St. Francis Health Services (now Franciscan Health) and Provena Health. The organization was formed to provide laboratory testing for its 18 hospitals. In 2008, Resurrection Health Care joined Alverno as an equal owner. In 2011, Resurrection Health Care and Provena Health merged to become Presence Health. Our facility in Hammond, IN, is what emerged from Dr. McBride’s vision.

What about the human aspect of laboratory consolidation—creating a uniform culture? How have you been able to do that? Is it an ongoing process? Creating a uniform culture takes time, hard work, dedication, and a commitment to continually foster the environment you envision. A few years back, we asked all associates (approximately 1,500 at the time) what they thought our values should be, and from that we created them. Our focus is on integrity, dedication to quality, commitment to service, and our faith. It is critical that our values align with our parent organizations. PCL Alverno has come a long way in creating a culture of high reliability and commitment to those we serve. We continue to focus on communication and engagement and have teams working on quality, regulatory, and clinical areas, but also to include the human side: employee relations and the customer experience. Finding ways to connect in an organization that now has associates in well over 100 sites of care is part of our continued focus on culture.

You have a lab background, including time managing the lab at Elmhurst Memorial Hospital in IL. How does your time in the lab continue to inform your efforts today? Having worked in the laboratory setting, from phlebotomy to performing various testing, has given me a perspective on what our employees and patients encounter each day. This knowledge guides me when I make decisions about everything from supply vendors to technology.

What are your goals for PCL Alverno in the years ahead? No doubt we are navigating through some choppy waters, as we have for decades and probably will for decades going forward;  no doubt we will experience legislative, reimbursement, and regulatory changes; this is the norm. One of the most urgent matters in our industry is having enough young people join the laboratory sciences field. We partner with various MT and MLT teaching institutions to provide students with the needed laboratory experience to reach their certifications and graduation requirements. This enables us to build relationships with these students in hope that they will join our team after graduation.

Another focus is to increase technology where it makes sense. We must prepare to do the work we do today with fewer laboratorians if the trend in our industry continues. Of course, we are also keeping a close eye on the move from conventional testing platforms that will be replaced by molecular biology testing platforms. We also cannot lose sight of the continued journey to create the culture we need to be successful—in hiring, performing quality testing, and providing the best care we can to those we serve. Most important is to stay focused on the great privilege we have in healthcare to touch the lives of so many. At PCL Alverno we have that opportunity millions of times each year.