Next week is National Medical Laboratory Week!
During the week of April 22 – April 25, LMP will be taking part in National Medical Laboratory Week – the annual celebration of our medical laboratory professionals who play a critical role in every aspect of health care.
As a laboratory professional, how do you help patients every day?
Create a short phrase that describes what you do in the lab – and it could be turned into a poster!
Submissions may be sent to LMP.Communications@uhn.ca and staff are encouraged to submit as many phrases as possible. The top three that best describe “life in the Lab” will be turned into posters – and you’ll win a prize.
NMLW Schedule of Activities!
Tuesday April 22
Time: 12 noon – 1 pm
Location: TGH Astellas Conference Room, 11th floor, Munk Building
Vendor Presentation – “What’s New at Stago” Gordon Odrowski, Stago
Educational Session – “Laboratory Medicine – Winds of Change”
Speaker: Tom Clancy
Educational Session: Student Testimonials
Speakers: Adedoyin Banjoko & Shadi Huladar, UOIT
Lunch Provided by: Stago
Weds April 23
Time: 12 noon – 1pm
Location: TGH Pathology Conference Room, 11th floor, Eaton Building
Vendor Presentation – “Near Patient CD4 Testing” Lori Apoll, BD Sciences
Vendor Presentation – “Patient Safety During Blood Collection” Suzanne King, BD Sciences
Educational Session – “Transplant – A Case Study”
Speaker: Dr. Kathryn Tinckam
Lunch Provided by: BD Sciences, Dessert by Tiera’s Chocolate Bar
Thursday April 24
Time: 11:45 – 12:45 pm
Location: TGH Astellas Conference Room, 11th floor, Munk Building 026
Vendor Presentation – “OSOM Rapid Test” Jay Palmar, Fisher Scientific
Educational Session – “Learning About, From and With Each Other in Laboratory Medicine”
Speaker: Debbie Rolfe & Tracy Paulenko
Lunch Provided By: Fisher Scientific & Life Technologies, Dessert by Analiza Aquino
Friday April 25
Time: 12 noon – 1 pm
Location: TGH Pathology Conference Room, 11th floor, Eaton Building
Vendor Session – “NGAL – A Novel Biomarker for Acute Liver Injury” Dean Nixon, Alere
Educational Session – “Facing Change”
Speaker: Peter Woo
Educational Session: Ontario Society of Medical Technologists, Karim Bhaloo
Lunch and Cake Provided By: Alere, Dessert by LMP
Recently, two Pathologists’ Assistants from the Laboratory Medicine Program, Samy Marzouk and Angela Anthony, had the opportunity to go up to the Sault Area Hospital, one of LMPs partners, and help out in their surgical pathology department.
The editorial team of The Pathology Report sat down with Samy and asked him some questions about why he went, what it was like working with the SAH team and what he says to those looking for other work and educational opportunities.
I worked in the surgical pathology department at SAH for almost the whole month of Feb and again in March as a PA.
Why are you there?
Due to a leave of one of their staff members, they have had a shortage of PAs in their laboratory. I was able to cover the leave. Angela Anthony, another one of the LMP’s PAs has also been able to help out and covered a few weeks. I worked as a PA in their surgical pathology area, just like I do here. They were quite backlogged, so I just worked hard and did as much as possible.
Why did you volunteer for this opportunity?
I really enjoy taking on new challenges and trying something new, so I saw this as the perfect opportunity. Plus, I really wanted to gain additional experience working in a different laboratory setting and meeting new colleagues.
Also, as an immigrant to Canada, I really enjoy being able to see different places in Canada and knew that I couldn’t let this opportunity go.
What is the surgical pathology area like at SAH?
They are a relatively new hospital, around 2 years old, so it felt like I was using brand new equipment in a new space. They are also quite busy for a relatively small population, so they see quite a few specimens. I can appreciate how it wouldn’t take long for them to get backed up.
Where did you stay?
I stayed at local hotel within Sault Ste Marie, close to the hospital. While I was there, I was able to attend Bon Soo, an annual winter carnival in Sault Ste. Marie. It was great to see this event as there were lots of tents, exhibits and ice sculptures.
Who did you work with?
I was able to work with some terrific people at SAH. I mainly worked with Dan, the senior PA and Drs Mike D’Agostino and Mozorowski. I also worked closely with Scott Bowman, the laboratory manager and Betty Currie, the lab technical supervisor, who was incredibly helpful in getting me settled. She even recommended an all you can eat sushi place.
The entire team has been very friendly and welcoming. I was initially hesitant because it’s always a little stressful going to work in a new place, but they all put me at ease and were very warm and gracious. I could also tell they are very passionate about their work, hardworking and committed to their patients.
Just that I’m excited to head up to SAH again. I really encourage everyone to take these kinds of opportunities, try new things and go to a new place. You get to meet new people and gain some really valuable experience.
Recently, Dr. Sylvia Asa, Medical Director, Laboratory Medicine was inducted as an honorary fellow of the Royal College of Pathologists.
The Royal College of Pathologists (RCP) is an organization whose mission is to promote excellence in the study, research and practice of pathology. They are also responsible for maintaining the highest standards through training, assessments, examinations and professional development, to the benefit of the public and the healthcare industry.
Most people become members of a College by examination, but on occasion, a fellowship is an honor that is bestowed on a prominent person to recognize their contribution to the field.
Congratulations to Dr. Asa for the tremendous honour as she joins a list of other champions in the world of pathology, including Lord Soulsby of Swaffham Prior (2004), The Baroness Trumpington of Sandwich (1991), Lord Crisp KCB (2009) and Dame Carol Black CBE (2004).
Written by: Kwabena Boateng, MLT, Laboratory Medicine Program
While only three per cent of bone marrow white blood cells have the CD34 molecule, these cells are responsible for helping the blood system in bone marrow transplant patients function normally after they have gone through cancer and chemotherapy. Rob’s studies of CD34 and the associated antibodies led to new methods of isolating these renewable stem cells.
Based on his work, Rob developed a very accurate flow cytometric assay to count CD34+ cells in the bloog. Circulating ‘stem cells’ were taking over from bone marrow as a source of stem cells in the transplant setting and accurate counting of CD34+ cells was essential to ensure that patients received enough to be effective.
When Rob’s method was published he was invited to write an International Guideline for assessing Blood Stem Cell grafts, but he immediately faced much criticism and hostility from some other researchers in the field and commercial enterprises whose own methods were shown to be sub-optimal.
This was a tough period as Rob publicized his methods at international meetings and had to respond to many attacks on his science. He ran workshops, identified and educated key leaders in the field, established close collaborations with more open-minded colleagues and published a number of Consensus Guidelines Documents until these methods became accepted as the best available.
“Change agents,” such as Rob Sutherland, can either be internal (managers/employees) or external (consultant from outside firm). The success of any change effort rests heavily on the working relationships between key decision makers and the change agent.
As Rob says, “this is what good science is about but it is also about the quality of patient care;” erroneous laboratory results can have very serious negative impacts on patients in the bone marrow transplant setting.
Rob’s work has helped transform what was once a risky treatment into one that is almost invariably safe and effective.
As a change agent, when leading a change effort, one must be able to envision, plan, implement, review and learn. Through the process of exploratory inquiries (asking key questions), one will be able to move towards diagnostic inquiries (solutions).
Change is good, but in an effort to implement great change, one needs to articulate a clear vision and form a strong coalition with like-minded colleagues to help communicate and execute the vision.
Ask yourself: what are you doing to become a ‘change agent’ in your area of the laboratory?
Recently, the Blood Transfusion team in the Laboratory Medicine Program (LMP) at UHN, along with our blood transfusion partners at Lakeridge Health, Sunnybrook and hospitals all across Ontario participated in a “mock blood shortage” exercise.
The exercise helped our team practice what would happen during a real and severe blood shortage — the reason for the shortage during this particular exercise, as provided by the Canadian Blood Services, was a major storm with the resulting closure of the city’s airport and highways.
In the event of a blood shortage, major surgeries are reviewed to see if the surgery will need blood and if so, the surgery is delayed until it is safe to proceed. In addition, transfusion orders for all inpatients and outpatients are carefully scrutinized to identify who can have their transfusion safely deferred and who might benefit from a transfusion-sparing alternative.
“Blood shortages have the potential to affect every patient in the hospital and, depending on where the shortage originated, every hospital in the province,” says Dr. Jacob Pendergrast, Blood Transfusion Specialist.
The Blood Transfusion Laboratory at UHN is partnered with blood banks throughout the GTA, including Sunnybrook and Lakeridge Health; and the team is also responsible for overseeing the blood transfusion laboratories in hospitals throughout Northern Ontario, including Sault Ste Marie, the Timmins region, and even as far north as Weeneebayko Area Health Authority in James Bay.
“During the mock blood shortage exercise, we worked with our partner hospitals to monitor blood product levels at all the sites,” explained Dr. Lani Lieberman, Blood Transfusion Specialist. “We had to make sure that all our patients, whether or not they were within the ‘walls’ of UHN, would be taken care of.”
They also call together the Emergency Blood Management Committee (EBMC) which consists of senior leaders and medical directors from across the organization who will make decisions around patient care if inventories reach a critical level.
“The team did an absolutely phenomenal job during the exercise,” says. Dr. Sylvia Asa, Medical Director, LMP. “They were organized, well prepared and confident in their plans – which they executed flawlessly. The team really demonstrated their commitment to patient care.”
“The blood transfusion team is always focused on delivering and managing quality blood products,” said Sally Balmer, Manager, Blood Transfusion. “The blood shortage exercise is just another example of how hard they work for our patients.”
“Every day our staff delivers exceptional patient care, “says Brad Davis, Executive Director, LMP. “I congratulate the entire blood transfusion team for their hard work during the “mock” crisis – but also for all the work they do day to day in our laboratory. Great stuff!”
Recently, the Laboratory Medicine Program’s Dr. Rasmus Kiehl spoke at the United States & Canada Academy of Pathology (USCAP) Conference in San Diego about his work turning pathology specimens into art.
Dr. Kiehl spoke about what inspires him to create his art, the methods his uses and what designs we might see from him next. Listen to his talk about the “art of pathology” and see if it inspires you to create some art of your own:
In May 2013, Princess Margaret hosted its 1st annual Goals and Objectives Retreat which was attended by almost 300 staff members, including representatives from LMP. During the retreat, the various units and departments set team goals for the upcoming year.
In October 2013, a Goal Reporting Day was held for teams to provide progress updates and learnings from their goals and members from LMP gave a presentation on “Understanding the Process and the Barriers of Timely Delivery of Specimens.”
Recently, the team was able to give a poster presentation of their goal at the 1st annual Princess Margaret Goal Reporting Poster Day that explained their goal and how it would improve patient care. The presentation addressed the following questions:
What did the team do to achieve the goal?
The team organized and participated in clinical working groups to ensure successful implementation of a variety of initiatives including; stem cell apheresis move to TGH; improved TAT of test results for urgent TFC patients and; improved blood transfusion communication via whiteboard notification. The team also -
- Worked collaboratively with all stakeholders to understand expectations and limitations
- Engaged staff for process improvement input
- Aligned clinic schedules with patient flow through blood collection centres, laboratory testing, transportation and treatment clinics
- Implemented a process of prioritization via use of visual flags
- Provided input in support of whiteboard improvement project
What was the outcome?
- Implementation of priority processes to facilitate optimization of treatment time for apheresis patients
- Improved TAT to facilitate treatment for urgent TFC patients
- Improved whiteboard communications (standard language, visual flags
Who was involved?
Dr. David Barth, Laurie Mason, Sally Balmer, Jay Hockley, Diana Booth, Fatima Cardoso, Gisele Thorpe, Maria Amenta and technicians in blood collection, including Patsy Raymond, and the team of technologists from hematology and blood transfusion.
What was the “Greatest Learning”?
The laboratory needs to be engaged to be able to understand the process because there is always a solution.
“What are you most proud of?”
The collaboration and engagement by all laboratory professionals was extraordinary. Everyone wanted to see the success of these initiatives because they could make the positive impact association with patient care.
Reflecting on the goal process, Maria Amenta thanked the team and explained that “thanks to input from Patsy Raymond, and the entire team of technicians in blood collection and the team of technologists working in hematology and blood transfusion, Transfusion Centre patients waiting to find out if they require blood products are now waiting less. Previously, results could’ve taken up to 60 min or longer, clinicians are now receiving results within 20 min and are able to make transfusion decisions that much sooner. Their commitment to improving patient care is what makes LMP succeed and excel in all areas of our laboratory.”