ASCLS Today

ASCLSToday Masthead 680

Volume 32, Number 3

Strengthening ASCLS Constituent Societies Through Communication

Deb Rodahl, MBA, MLS(ASCP)CM, ASCLS President

In my president’s acceptance speech, I noted that I plan to focus my efforts on areas that have been identified as a need in our organization; Leadership Development, Mentorship, Communication, and Professional Involvement. It is time to tackle the illusive topic of communication.

Communication is a very challenging dynamic when you start to think about the types of communication platforms, timing, audience, etc. Within ASCLS, communication is utilized to share all kinds of information (updates, science, operations), as well as providing a strategy for how the organization is marketing itself to the rest of the world. Depending on the information communicated, there are very different needs. Some information is time sensitive such as legislative updates, highlights from the Annual Meeting, or requests for nominations and volunteer opportunities. Other communications are less time-sensitive and may be geared toward education.

ASCLS has a variety of communication platforms: Clinical Laboratory Science Journal, ASCLS Today newsletter, and the Connect Community Forums.

The Clinical Laboratory Science Journal is our shining star for a peer-reviewed journal that allows our members to publish their research. The editing process for this communication mechanism is well understood by the authors and traditionally the journal is not intended for time-sensitive information. In March 2017, the Board of Directors decided to invest in the needed infrastructure to publish the journal so it could be properly indexed. The new software and infrastructure offer several enhancements to automate the article submission and editing process, which will reduce the length of time from submission to publication. The result will be well worth the journey, and many thanks go out to Suzanne Campbell for her vision for this project and to Perry Scanlan for helping to move the vision to reality.

Historically, we have relied on ASCLS Today to deliver most of our society news. It has always been jam-packed full of great updates from across the organization. We have always been very intentional about the timing of articles, scheduled months in advance. This is all part of the editing, design, and publication process. ASCLS Today is one of the very visible marketing and communication tools we have, so it is critical that it is produced well. 

Last Summer it became very evident we were experiencing a challenge to balance the daily priorities of running ASCLS with the extra projects that had been commissioned and required much support of our staff. At the same time, the long time, trusted contractor for ASCLS Today fell ill and was no longer able to support our work. This resulted in a communication silence at a time when our staff were extremely busy with the other projects in progress. At the Annual Meeting, our members requested the Board of Directors review the challenges with publishing ASCLS Today and to develop a more comprehensive communication plan.

In September, the ASCLS Executive Committee heard a presentation from Executive Vice President, Jim Flanigan, that very well-articulated the communication needs in ASCLS and how that also supports our ability to market who we are. After a lengthy discussion, the Executive Committee realized that an underlying need for ASCLS was to find a way to add a marketing and communications role within ASCLS to manage the design and production of the newsletter, while furthering our marketing and communication strategy. This resulted in a proposal to the Board of Directors in November and the hiring our Director of Marketing and Communications, Lindsay Kamowski. Lindsay comes with great experience, working with other professional organizations and was quick to put together a comprehensive published communication plan.

  1. Time sensitive information will continue to be pushed out on the ASCLS Community Forums and Open Forum. Community Forum communication is increasing as more members see the value of the regular updates and ability to dialogue with each other on important matters.
  2. The ASCLS Society News Now will be the venue for regular communication of time-sensitive information including nominations, volunteer opportunities, committee highlights, legislative updates, and more.
  3. ASCLS Today will continue to publish updates from within the organization on a regular schedule. This newsletter provides valuable information and supports a marketing strategy for the organization. It is available in print and electronic formats.
  4. The Clinical Laboratory Science Journal will continue to publish peer reviewed articles submitted by laboratory professionals utilizing our new electronic publishing platform.

Communication is a critical strategy and need within ASCLS. While the delays in publishing our ASCLS Today newsletter has been frustrating for all of us, it highlights the value it provides to our members and ASCLS as an organization. Please accept our apology for this gap and know that we have come out of this challenge in a much better place. It truly is my honor to serve as ASCLS President!

Journey Toward Leadership Development: Region II Leadership Academy

Julie Bayer-Vile, MS, MLS(ASCP)CMSCCM, MBCM; Mary Ann McLane, PhD, MLS(ASCP)CM; Stephanie Noblit, MLS(ASCP)CM; Catherine Otto, MLS(ASCP)CM
Region II Leadership Academy Task Force

Leadership within any endeavor carries certain universal characteristics in the people who are considered leaders, the instances that call for leadership, and the individuals who are led. Where there is much controversy over the statement, “leaders are born, not made,” those of us who have committed to involvement in ASCLS, our careers, or our families know that leadership is a dynamic skill that is different for a given setting. What is not in debate is the need for someone in every situation to step forward and make the impossible possible, foster a vibrant and creative environment, and to be skilled in persuading people to do what needs to be done.
 

Ten years ago, the ASCLS Board of Directors recognized the need for our members to experience an intensive group effort focused on developing leadership skills. The national Leadership Academy was developed. Region II recently recognized the need, as have other ASCLS regions and states, for a regional Leadership Academy to help foster the leadership potential of our members. A task force was formed in October 2016 to help shape our vision for the Leadership Academy. 

Our biggest challenge was deciding how to adapt the existing format to best serve the needs of our state societies and our members without duplicating the material presented in the national Leadership Academy. Using guidance, experience, and suggestions gathered through discussions with other regional Leadership Academy leaders, our state leaders, and our region’s members, we were able to identify the components that would be most beneficial for our region. Our main goal was to develop a Leadership Academy with content designed to be applicable to the participant’s future experience with ASCLS, but that was also applicable to their careers in clinical laboratory science. 

We view our Leadership Academy as a gateway to further ASCLS involvement and future national Leadership Academy participation. As such, we decided to forego a class project and have our Academy be content and discussion-driven. We utilize a forum in the ASLCS online community to facilitate discussion among our participants as a way of furthering the conversation and learning around our chosen topics of instruction. We hold monthly webinars on a wide range of topics, including:

  • The History of ASCLS
  • Leadership, Vision, and Goal Setting
  • Team Building
  • Mentoring and Coaching
  • Networking and Advocacy
  • Recruitment and Retention
  • Promotion of the Profession
  • Successful Meetings
  • Strategic Planning

We conduct monthly webinars using Zoom and our Academy is free for all participants. Our speakers are experienced leaders in ASCLS at the local, regional, and national levels. Each of the committee members speak, along with our Region II director, Nadine Fydryszewski; ASCLS Executive Vice President Emeritus, Elissa Passiment; and other leaders from within and outside our region. Each session provides P.A.C.E.® credit for our participants.

The application was opened in July 2017 with a maximum capacity of ten. We felt this number would allow for a diversity of voices and experiences, while not proving too overwhelming for our class. In August 2017, we decided to open admission to our neighbor, Region I. The only requirement for application was membership in ASCLS. Continued participation is contingent upon active participation and attendance for the webinars. To graduate from our regional Leadership Academy, participants must participate in at least two thirds of our conference calls. We are expecting to graduate seven from our first class in June 2018.

The process of developing and executing this Leadership Academy has been a learning experience for the committee. Our challenges have included finding a presentation time conducive to as many schedules as possible, determining our outcome measures for success, and fostering an environment for active discussion and networking. We’ve gotten valuable feedback from our participants on how to improve and enhance the experience for our next group. We are grateful for the guidance and support we’ve received from our fellow regional Leadership Academies, from our presenters, and most of all, from our participants. The members of our first class come with an amazing level of potential for leadership in ASCLS and in the clinical laboratory. We are proud of what they are learning and appreciate their willingness and enthusiasm in leading us through this process.

 

Professionalism Requires Continuous Improvement

Darius Y. Wilson, EdD, MAT, MT(ASCP), MLS Program Chair, Baptist College of Health Sciences

As an educator, it is my responsibility to teach and, more importantly, model professionalism to medical laboratory science students and even colleagues. Students have participated in various clinical rotations and have given reports of unprofessional behavior in the workplace. Rather than spend time discussing the reported behavior, I focus on the type of behavior that should be presented.

One would think that in 2018, the topic of professionalism would be obsolete; however, it remains a timeless classic. The implementation requires continuous improvement. One must always think of one’s presentation to another, whether in the workplace or in public. Competency in professionalism tends to involve non-cognitive skills, including communication (language, empathy, integrity, compassion), collaborator (responsibility, respect, duty), and continuous improvement (recognition of limitations, motivation to improve). One should establish a personal barometer to gauge the necessity for improvement.

Per David Tipton (2017), Professionalism is a set or values, attitudes, beliefs, and behaviors. The term includes a commitment to the highest standards of excellence in practice; a commitment to the interest of patients; and a commitment to the needs of the community. Educators, lab supervisors, and lab directors should be involved in teaching professionalism by setting expectations, performing assessments, rewarding appropriate behaviors, remediating and/or preventing inappropriate behaviors, and implementing a cultural change.

Utilizing several resources, below are some major characteristics of a quality healthcare professional:

  • Dependable
  • Cooperative
  • Committed
  • Compassionate
  • Courteous
  • Respectful 
  • Competent
  • Integrity
  • Technical skills
  • Personal growth
  • Organized
  • Flexible
  • Neat and clean appearance
  • Good communication skills (verbal and nonverbal)
  • Good telephone skills

Some of the characteristics listed above are soft skills, which are difficult to evaluate. However, soft skills are very important for employment and life in general. Those are the interpersonal skills, i.e. how well one gets along with others. For example, an employer shared with me that it is very difficult to teach customer service skills, but much easier to teach one how to troubleshoot if they have the basic competency. The competency in an area is the knowledge and skill most often learned in a classroom or clinical setting. These are the hard skills, which are quantifiable attributes. 

It is the responsibility of each individual to evaluate his/her level of soft and hard skills. As an educator, it is my responsibility to assist the student in evaluating the soft skills and provide the educational components to achieve the hard skills in medical laboratory science. I would be remiss if either is ignored. 

In addition, it is the role of the educator to promote involvement in a professional organization. This is also a component of professionalism. I share with students my involvement and promote attendance at local meetings. As the title states, professionalism requires continuous improvement. Although I have been an educator for many years, I continuously strive to improve so I can assist others to meet their goals. 

REFERENCES

  1. Personal and Professional Growth for Health Care Professionals, David Tipton, 2017
  2. The Phlebotomy Textbook, Susan King Strasinger & Marjorie Schuab DiLorenzo, 2011
  3. Professionalism in Healthcare, Sherry Makely, 2013

Our Darkest Hour: Las Vegas Mass Shooting

Shannon Billings, MS, MLS(ASCP)CM, Laboratory Manager, Desert Springs Hospital Medical Center, Las Vegas, Nevada

Most mass casualty stories are told from the point of view of the victims or the first responders, the doctors, medics, nurses, or police. 

This is not that story.

Sunday night began as an ordinary night at Desert Springs Hospital Medical Center (DSH), a 293-bed, acute care community hospital in Southeast Las Vegas. In the laboratory, three techs and four phlebotomists were on duty for the night shift. Everyone was hoping for an ordinary night to wrap up their 3rd 12-hour shift in a row. This was the last day on their shifts.

It had been a relatively slow night; however, everything rapidly changed and ordinary turned to extraordinary as disaster and tragedy struck. Three miles west on the Las Vegas strip, the Route 91 Harvest Festival was enjoying one last night of live country music. At 10:05 p.m., as 20,000 attendees reveled and celebrated, shots rang out upon the crowd below from the 32nd floor of the Mandalay Bay Hotel and Casino and chaos ensued. More than 900 rounds were fired into that crowd, injuring 498 people and killing 58.

Shortly thereafter, the crew in the lab at DSH was shaken out of their slow night as an overhead page announced, “CODE TRIAGE EXTERNAL, CODE LOCKDOWN.” DSH is not a trauma center, but it was the closest hospital to the mass shooting.

News might travel fast in our modern world, but the news of the mass shooting hadn’t traveled fast enough yet to hit the staff on duty. This was their first warning that something big was happening nearby in the outside world.

Every hospital practices, drills, and works on policies and procedures for how to handle disasters. No amount of practice, drilling, and procedure-writing will ever prepare someone for the real deal. 

Gunshot wound victims started pouring into the emergency room at a rapid pace. They came by Uber, bus, stolen truck, taxi, private vehicle, police escort, and ambulance. Drivers were using the Internet to find the nearest hospital: DSH. They came any way they could, the walking wounded, the seriously injured, of all shapes and sizes and trauma levels. With only 11 nurses on staff in the emergency room (ER), nurses and hospital personnel from across the hospital came down to help, as more were called in for the crisis. One ER doctor recalls that it escalated quickly from a trauma to more of a war zone mentality. DSH essentially became the combat support hospital. The ER quickly began to run out of supplies and patient identification was difficult. Many patients had field tourniquets on as doctors were quickly writing diagnoses and treatment instructions on victims’ arms, hands, or on paper and pinning it to their shirts. IVs were being hung on walls by thumb tacks as there were no longer any spare IV poles in the hospital.

It all happened so fast the hospital didn’t have time to set up the labor pool, implement the triage telephone tree, or set up an official incident command. Initially DSH was notified to expect to receive no more than 50 victims. The final count was over 100 injured victims and that does not include the dozens handled by the hospital transfer center. “Send us your walking wounded,” was the word coming in from hospitals across the entire Valley, “We can take them.”

As soon as the code went off in the laboratory, staff did what any modern curious individuals did: looked it up on their smart phones and saw news of an active shooter on the strip. Most didn’t think anything of it at that time, as shootings are not uncommon in major metropolitan areas. The lab was still quiet. It wasn’t until the ER hit 50 patients that phlebotomist Jennifer Grant stepped into the ER, just on the other side of the door from the laboratory, to investigate what was going on. Her return was greeted with shock and dismay. She announced in horror, “they need towels to soak up all the blood!” And so, Jennifer Grant and Noe Huerta, another phlebotomist, had found their task for the crisis: passing out towels, holding pressure, spiking IVs, moving beds, supplying gloves, and handing out water, food, and free hugs to all the victims. Jennifer Grant rolled up towels to form makeshift pillows for the victims on the floor, as bed capacity was swiftly surpassed. Noe Huerta gave away his cell phone charger to someone who needed it more than he did.

The other two phlebotomists had a daunting task: they drew blood from every single victim that showed up in the ER, not waiting for orders from the attending doctors. Every patient had a type and screen, plus every color of the rainbow drawn in preparation. Some had patient stickers on, some were hand-written because admitting hadn’t caught up with the mass influx of casualties yet. Over 100 patients in the ER had blood drawn by AJ Ramos and Shelly Co Yu that night. They triaged by drawing the gunshot wound victims first. Patient identification wasn’t always easy. AJ even donned a surgical gown to draw the patients in the operating room (OR). The teamwork and organization of the phlebotomy staff that night was incredible. The phlebotomists paved the way for the medical technologists to manage blood supply and run critically important lab tests with minimal interruptions.

As news started to trickle in, the shift lead in charge, Jennifer Patterson, made a quick decision to call in another tech. Julia Wierzbicki, a day shift blood banker, had just fallen asleep when she received the phone call to return to work. She was back at work within thirty minutes.

The blood bank at DSH was quickly informed that the blood supplier had “logistic issues,” and that the trauma centers would take priority. In other words: what we had was all we were going to get. It was going to take some creativity to make the blood supply last. Pathology swiftly gave approval to give O positive in lieu of O negative to all male patients, and to give O positive to all female patients once the small supply of O negative ran out. DSH had a total of 37 units of type O blood on hand, and over 100 victims in the ER.

Jennifer Patterson coordinated with key staff members in the ER and OR to only use emergency blood if absolutely needed, and to return it as swiftly as possible after the patient was triaged and found to be hemodynamically stable, as the blood supply across the entire Valley was instantly critically short. With the help of the other two techs on duty, Michael Leonardo and Allan Luzon, along with the swift return of Julia Wierzbicki, all 37 units of type O blood were setup for emergency release. Jennifer Patterson stated that it evoked a somber and eerie feeling to look at all those units with uncrossmatched labels on them.

Julia handled running types and screens while Jennifer set up coolers of blood and issued, delivered, and managed the inventory of emergency uncrossmatched blood. The entire staff was humbled and amazed as phone calls came in and coolers were returned as soon as it was determined that blood wasn’t needed. I hesitate to say that angels were watching over us that night, but by 4 a.m., we still had 33 units of type O blood on the shelf, and the crisis was over. We transfused more units the next day during surgery patching people up after they were stabilized than we did during the entire crisis itself, and we never once ran out of any type of blood. This would not have been possible if the doctors and nurses didn’t make those critical decisions and follow-up phone calls. 

Jennifer recalls one trip to the ER to deliver emergency uncrossmatched blood:

“I wasn’t prepared for what I saw. There were people, beds, and blood everywhere. So many men were running around without shirts and I found that odd. Later I learned it was because their shirts were used as tourniquets for the victims. Making my way to the back of the ER was like walking through a crowded bar. There was chaos all around. Having a hospital badge around my neck made me a target for those needing assistance. That was the hardest part. We are trained from day one that no matter what you are doing, you stop and help anyone who needs it for whatever reason. I had life-saving blood that needed to be delivered and I had to walk by those in need. A young man informed me that the girl he was with needed to use the restroom. I could only tell him where the restroom was located, and it broke my heart to see her lying in a bloody bed in the middle of the hallway. There was no way she could just get up and walk to the restroom. I had to keep going and felt like a horrible person because they had no way of knowing that I was on a different mission.”

Meanwhile, back at the lab after dealing with the blood crisis, things were settling down and running smoothly. The blood bank might have gotten the spotlight, but the rest of the lab still needed to function. Med techs Michael and Allan were running the show, taking care of hematology, chemistry, all the daily maintenance, QC, and other required bits and pieces. The rest of the night shift hospital staff knew what the lab was dealing with in the ER. The normal issues that pop up throughout a shift just didn’t seem very important that night. The interdepartmental cooperation and solidarity had never been higher. 

By 4 a.m., the crisis was wrapping up. The Code Lockdown had ended, and the hospital entrances were no longer under guard. The DSH lab staff finally had a chance to breathe, take a break, and catch up on the news. What they learned astounded them. Of nearly 500 people injured, DSH had received a total of 105, more than the only Level 1 Trauma Center in the Valley had received. Of 105 victims, only four passed away. 101 people had their lives saved with the help of my staff.

By 6:30 a.m., when I came into work, my staff looked exhausted, worn down, tired, bloody, and battered, but not beaten. Haunted expressions in their eyes and they were being fueled on sheer adrenaline and determination. I asked Jennifer Patterson why she didn’t call me; I had received a code triage and code lockdown text, but I was asleep, and the texts were very vague, so I didn’t think anything of it, knowing if it was a real crisis and I was needed, they would call and wake me. Her response: “I had considered it, but we were able to handle it, and someone has to come in and clean up this mess and keep everyone going through the rest of this, and that’s you.”

The crisis might have been over, but the emotional roller coaster was just beginning as the entire city went through the grief cycle. But we did it together. As one we cried, we shouted our anger to the skies, we bargained, we mourned, and we accepted our losses. The marquees of all the casinos and hotels displayed messages of solidarity for weeks: “#vegasstrong.” “We were there for you during the best of times, thank you for being there for us during the worst.’ “Las Vegas is the city of lights. Even in our darkest hour we still shine.”

We received cards, gifts, and care baskets from across the country, and messages from around the world. My staff was humbled and grateful and in awe at the kindness of strangers. Thank you for being there for us in our darkest hour. We still shine.

 

Moving ASCLS Forward – Priority Pillar: Collaboration

Suzanne Campbell, PhD, MLS(ASCP)CM, ASCLS Past President

The next pillar of our Strategic Map is collaboration. Just as we see the benefit of unified voices versus that of an individual, it is in the best interest of ASCLS to collaborate with other laboratory organizations. Throughout the years, ASCLS leaders and staff have developed ties with the American Association for Clinical Chemistry (AACC), the American Society for Clinical Pathology (ASCP), the Clinical Laboratory Management Association (CLMA), the American Medical Technologists (AMT), and the National Independent Laboratory Association (NILA) to name a few. Other strategies for collaboration include inter-professional education among various members of the healthcare team. Lastly, ASCLS will continue to take full advantage of the sponsoring role for the National Accrediting Agency for Clinical Laboratory Science (NAACLS) and the ASCP Board of Certification Board of Governors. 

The partnership with AACC and ASCLS has benefited members of both organizations with top notch continuing education opportunities in conjunction with the world’s largest laboratory exposition at the Annual Meeting. Members of executive committees of both organizations have traditionally met during the Annual Meeting to share updates on goals and projects as well as to identify future collaborative endeavors.

As we have done for almost 30 years, ASCLS, ASCP, CLMA, AGT and AMT met for another successful Legislative Symposium in Washington, DC. The selected topics for members to take to their congressmen on Capitol Hill was a request for a delay in the laboratory fee schedule implementation as part of the Protecting Access to Medicare Act (PAMA) and a request to address the continued laboratory workforce shortage. 

Topics covered include issues like the CMS ruling indicating a bachelor’s degree in nursing is equivalent to a bachelor’s degree in biological science. Such a ruling would allow registered nurses to perform moderate and high complexity testing. ASCLS and ASCP worked closely together on a petition to reverse the ruling with 30,000 signatures was presented to CMS in June 2016, noting the concerns related to quality laboratory testing if performed by non-laboratory professionals. Laboratory organization officials continue to urge CMS to immediately reverse this ruling.

In the future, ASCP and ASCLS will strive to align the timelines for the ASCP Practice Analysis survey and the ASCLS Body of Knowledge entry level curriculum review. It is in the best interest of industry and academia to share the findings of these projects and to join forces to ensure alignment of educational theory and technical competencies with industry practice.

The Doctorate in Clinical Laboratory Science (DCLS) degree will open the doors for advanced practice laboratory professionals to work inter-professionally to improve diagnosis, treatment, and disease prevention modalities. The DCLS will be an important member of hospital utilization and review teams as well as a consultant to the infection prevention department. 

As a sponsoring organization of NAACLS, ASCLS has a vested interest in academic programs to include the program faculty and students. Program directors and faculty who are actively engaged in ASCLS are ideal role models for students. The ASCLS Student Forum provides excellent opportunities for students to be involved at the state, regional, and national levels. Our challenge is retaining student members as they graduate and transition to first year professional status. 

Members of ASCLS are appointed to the ASCP Board of Certification (BOC) Board of Governors and play an important role in making decisions that guide the future of the BOC. Additionally, ASCP provides ASCLS with contact information for examinees that have recently passed the certification exam. This enables ASCLS to contact new professionals to promote membership in the premier laboratory organization that is governed by one’s peers. 

ASCLS maintains representation in the following entities: Health Professions Network, American Hospital Association, International Federation of Biomedical Laboratory Science, Clinical Laboratory Standards Institute, Coordinating Council for Clinical Laboratory Workforce, and the Joint Commission Professional and Technical Advisory committee. It is vital that the interests of medical laboratory professionals are expressed to these organizations. 

It is imperative to the future of our profession that efforts to collaborate with the multitude of laboratory organization are developed, maintained, and expanded. A unified effort to advocate for and to promote laboratory professionals as well as our critical role as a member of the healthcare team results in One Voice, One Vision. Together we can not only Move ASCLS Forward but move the collaborative efforts of multiple organizations forward.