Medical Laboratory Observer - April 2026

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Strengthening laboratory

through continuous learning

Dan Scungio, MLS(ASCP), SLS, CQA (ASQ) and Jason P. Nagy, PhD, MLS (ASCP)CM,QLS

The case for interference-free glucose meters

Vol. 58, No. 3

EDITOR IN CHIEF Christina Wichmann cwichmann@mlo-online.com

MANAGING EDITOR Erin Brady ebrady@endeavorb2b.com

PRODUCTION MANAGER Edward Bartlett

ART DIRECTOR Kelli Mylchreest

AUDIENCE DEVELOPMENT/LIST RENTALS Laura Moulton | lmoulton@endeavorb2b.com

ADVERTISING SERVICES MANAGER Karen Runion | krunion@endeavorb2b.com

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EAST COAST/MIDWEST SALES, CLASSIFIEDS Carol Vovcsko (941) 321-2873 | cvovcsko@mlo-online.com

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MLO EDITORIAL ADVISORY BOARD

John Brunstein, PhD, Biochemistry (Molecular Virology) President & CSO PathoID, Inc., British Columbia, Canada

Lisa-Jean Clifford, COO & Chief Strategy Officer Gestalt, Spokane, WA

Barbara Strain, MA, SM(ASCP), CVAHP Principal, Barbara Strain Consulting LLC, Formerly Director, Value Management, University of Virginia Health System, Charlottesville, VA

Jeffrey D. Klausner, MD, MPH Professor of Preventive Medicine in the Division of Disease Prevention, Policy and Global Health, Department of Preventive Medicine at University of Southern California Keck School of Medicine. Donna Beasley, DLM(ASCP), Director Huron Healthcare, Chicago, IL

Anthony Kurec, MS, H(ASCP)DLM, Clinical Associate Professor, Emeritus , SUNY Upstate Medical University, Syracuse, NY

Suzanne Butch, MLS(ASCP)CM, SBBCM, DLMCM Freelance Consultant, Avon, OH

Paul R. Eden, Jr., MT(ASCP), PhD, Lt. Col., USAF (ret.) (formerly) Chief, Laboratory Services, 88th Diagnostics/Therapeutics Squadron, Wright-Patterson AFB, OH

Daniel J. Scungio, MT (ASCP), SLS, CQA (ASQ), Consultant at Dan the Lab Safety Man and Safety Officer at Sentara Healthcare, Norfolk, VA

CORPORATE TEAM

CEO Chris Ferrell

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CDO Jacquie Niemiec CALO Tracy Kane

CMO Amanda Landsaw EVP INFRASTRUCTURE & PUBLIC SECTOR GROUP Kylie Hirko VP OF CONTENT STRATEGY, INFRASTRUCTURE & PUBLIC SECTOR GROUP Michelle Kopier 30 Burton Hills Blvd., Suite 185 Nashville, TN 37215 800-547-7377 | www.mlo-online.com

Medical Laboratory Observer USPS Permit 60930, ISSN 0580-7247 print, ISSN 2771-6759 online is published 10 times annually (Jan, Mar, Apr, May, Jul, Jul-CLR, Aug, Sep, Oct, Nov) by Endeavor Business Media, LLC. 201 N Main St 5th Floor, Fort Atkinson, WI 53538. Periodicals postage paid at Fort Atkinson, WI, and additional mailing offices. POSTMASTER: Send address changes to Medical Laboratory Observer, PO Box 3257, Northbrook, IL 60065-3257. SUBSCRIPTIONS: Publisher reserves the right to reject non-qualified subscriptions. Subscription prices: U.S. $164.80 per year; Canada/Mexico $199.56 per year; All other countries $284.54 per year. All subscriptions are payable in U.S. funds. Send subscription inquiries to Medical Laboratory Observer, PO Box 3257, Northbrook, IL 60065-3257. Customer service can be reached toll-free at 877-382-9187 or at MLO@ omeda.com for magazine subscription assistance or questions Printed in the USA. Copyright 2026 Endeavor Business Media, LLC. All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopies, recordings, or any information storage or retrieval system without permission from the publisher. Endeavor Business Media, LLC does not assume and hereby disclaims any liability to any person or company for any loss or damage caused by errors or omissions in the material herein, regardless of whether such errors result from negligence, accident, or any other cause whatsoever. The views and opinions in the articles herein are not to be taken as official expressions of the publishers, unless so stated. The publishers do not warrant either expressly or by implication, the factual accuracy of the articles herein, nor do they so warrant any views or opinions by the authors of said articles.

Lab stories

By Christina Wichmann Editor in Chief

Happy Medical Laboratory Professionals Week! This year, Lab Week is celebrated April 19–25. This year’s Lab Week theme was inspired by the Pixar movie Toy Story — Lab Story: To Infinity and Beyond for our Patients! That theme is perfect for this month’s issue of MLO where we get to announce this year’s Lab of the Year winner and two runners up, because these laboratories are going to infinity and beyond for their patients!

This year’s Lab of the Year is UHealth Laboratories, University of Miami Health System. UHealth is South Florida’s only university-based medical system. 630 full-time equivalent staff are employed by UHealth Laboratories who provide patients and providers timely access, dependable turnaround times and results, and a courteous, professional experience. Patient feedback indicated that 91% had positive personal interactions with the laboratory and 83% expressed confidence in the laboratory’s ability to meet their needs. Customer service is further strengthened by laboratory teams coordinating between hospital-based labs, ambulatory centers, oncology satellites, and specialized facilities to maintain service stability under changing operational conditions. When workload surges or instrumentation challenges arise, sites support one another through workload redistribution, back-up testing, and coordinated courier movement.

Productivity is also a stellar attribute of UHealth Laboratories. A commitment to eliminating waste, reducing variation, and strengthening the flow of services across the laboratory network guide daily operations and ensure that the laboratory system maintains reliable turnaround times, even as testing volumes continue to grow. All workflows are mapped, documented, and maintained in Policystat and are regularly reviewed to enable teams to identify and correct inefficiencies and align processes with best practices. Performance monitoring is embedded into routine laboratory operations through dashboards, executive reviews, departmental meetings, operational huddles, and one-on-one performance discussions.

The two runners-up for the Lab of the Year award are Atrium Health Cabarrus Laboratory in Concord, North Carolina and Inova Blood Donor Services in Sterling, Virginia. Atrium Health Cabarrus Laboratory has 65 full-time equivalent staff who are committed to improving processes in the laboratory. For example, to enhance patient safety across the health system, the laboratory partnered with the hospital’s nursing department on the impacts of properly labeling tubes, hemolysis, low-volume specimens, contamination, order of draw, and clotted specimens to prevent preanalytical errors. The laboratory also developed a multidisciplinary specimen collection workgroup with nursing to standardize workflows and use shared dashboards to pinpoint defect trends in real time.

Inova Blood Donor Services integrates laboratory excellence and donor services to support trauma and emergency care affecting more than eight million people across Virginia, Maryland, and the greater Mid-Atlantic region. Eight full-time equivalent techs perform all the laboratory testing. Inova performed 739 blood drives in 2025, and their commitment to guaranteeing the blood supply’s safety, purity, and potency is demonstrated through meticulous handling of donor collection, laboratory tests, component processing, and distribution.

So many wonderful nominations came in this year, and it is an honor to learn about all the important work that you do. Thank you for all you do, and Happy Laboratory Professionals Week!

I welcome your comments and questions — please send them to me at cwichmann@mlo-online.com.

Fast Facts

The impact of MLO’s Lab of the Year recognition

During the first months of the year, Medical Laboratory Observer (MLO) asked lab professionals what winning MLO’s Lab of the Year recognition would mean for their labs. They emphasized a number of benefits the award would bring their organizations. Key findings:

52%

selected staff recognition that can boost team pride, strengthen engagement, and support retention as the most appealing outcome.

21%

chose tangible proof of impact and excellence when communicating with executives regarding capital investments, staffing resources, and technology upgrades.

14%

said the cover feature and in-depth editorial coverage showcasing our operational excellence to a national audience.

7%

reported that winning would bring recruitment value that helps attract top talent and strengthens laboratory branding.

7%

said winning would reinforce expertise and trust with clinicians and healthcare partners.

Study

finds effective strategy to slow dementia progression

A two decades-long study discovered a method that slows dementia, according to a National Institutes of Health (NIH) announcement.

The study found that a rapid object detection task-based cognitive training lessened dementia diagnosis in adults over age 65 by 25%. More than 2,000 adults participated in the cognitive training for at least one hour two times a week for five-six weeks in 1999. Follow-ups were performed by 2019. “The interventions were designed to improve one of three kinds of cognitive function: memory, reasoning, and visual speed of processing,” NIH said.

Participants that experienced a slowed dementia diagnosis were given speed training plus “additional training at a later date.”

Innovative blood test detects Alzheimer’s disease via protein structure changes

Recent National Institute on Aging (NIA)-funded research has uncovered a new kind of blood-based biomarker test to diagnose Alzheimer’s disease. The new test broadens scientists’ understanding of Alzheimer’s disease by revealing shifts in a patient’s protein structure, according to an NIH announcement.

By utilizing mass spectrometry and machine learning to review more than 500 blood plasma samples from participants with Alzheimer’s, mild cognitive impairment, or those with neither diagnosis, the researchers pinpointed “changes in protein structure associated with genetic risk for Alzheimer’s—specifically in variants of the ApoE gene.” An association between those changes and neuropsychiatric symptom differences in males and females was also found.

Furthermore, the researchers “used machine learning to develop a diagnostic panel of three proteins—C1QA, CLUS, and ApoB—representing Alzheimer’s-associated structural changes.” It successfully differentiated between the three study groups and monitored disease stages and advancement, according to the National Institutes of Health (NIH).

The study authors hope these findings lead to earlier Alzheimer’s diagnoses, improving patient outcomes.

Blood test forecasts when Alzheimer’s symptoms might begin, study finds

The Washington University School of Medicine in St. Louis developed a tool to estimate Alzheimer’s symptom onset years earlier using only a single blood test, according to an announcement from the university.

The tool is a predictive model that utilizes p-tau217 to evaluate what age a patient will be when their symptoms will start. The researchers used data from 603 older adults who participated in the WashU Medicine Knight Alzheimer Disease Research Center (Knight ADRC) and the Alzheimer’s Disease Neuroimaging Initiative (ADNI). They primarily used WashU’s C2N Diagnostics-developed blood test, PrecivityAD2, to calculate plasma p-tau217. Blood tests from other companies were used on the ADNI group.

Lead author Kellen K. Petersen, PhD explained in WashU’s press release that amyloid and tau can reveal Alzheimer’s symptom onset, depending on their pattern. “We found this is also true of plasma p-tau217, which reflects both amyloid and tau levels,” he said.

The predictive models proved reliable for forecasting “the age of symptom onset within a margin of error of three to four years.” Additionally, “older individuals had a shorter time from when elevated p-tau217 appeared to the start of symptoms as compared to younger participants, suggesting that younger people’s brains may be more resilient to neurodegeneration and that older people may develop symptoms at lower levels of Alzheimer’s pathology.” Study results were the same regardless of the blood test the researchers used.

Healthgrades 2026: 438 top hospitals for patient safety

Healthgrades has recognized 438 hospitals in 40 states for being the top 10% in the nation for patient safety in its 2026 Patient Safety Excellence Award. Patient safety ratings evaluate the safety and quality of care at a hospital by measuring the rate at which serious, potentially preventable complications and adverse events occurred in the hospital.

To evaluate hospital patient safety, Healthgrades uses inpatient data from the Medicare Provider Analysis and Review

(MedPAR) file and the Agency for Healthcare Research and Quality’s (AHRQ) Patient Safety Indicators Technical Specifications and AHRQ WinQI software (version 2025 ICD-10-CM/ PCS August 2025). Learn more about the methodology on Healthgrades’ website.

The states with the most hospitals recognized by Healthgrades for patient safety were Texas (62 hospitals), California (54 hospitals), Florida (43 hospitals), Pennsylvania (33 hospitals), and Illinois (23 hospitals).

If all hospitals performed similarly to the 2026 Patient Safety Excellence Award winners, 100,819 patient safety events could have been avoided between 2022 and 2024.“The data behind this year’s Patient Safety Excellence Award highlights how measurable improvements in safety can prevent thousands of complications,” said Dr. Alana Biggers, MPH, medical advisor at Healthgrades. “Hospitals that prioritize evidence-based safety practices not only achieve better clinical outcomes, but also cultivate a culture where patients come first.”

New WHO recommendations for TB testing to enhance early detection and accessibility

The World Health Organization (WHO) announced they are working on updating their tuberculosis (TB) guidelines. Included in WHO consolidated guidelines on tuberculosis. Module 3: Diagnosis. 2nd edition will be WHO’s new recommendations for TB testing.

The goal of this action is to help healthcare professionals diagnose the disease earlier and to broaden TB testing accessibility. WHO’s recommendations are new near-pointof-care nucleic acid amplification tests (NPOC-NAATs), with tongue swabs (if patient cannot produce sputum) for specimen collection for diagnosing TB without rifampicin resistance. Tongue swabs can also be used with low-complexity automated NAATs (LC-aNAATs). It is important to note that NPOC-NAATs are suggested by WHO for peripheral levels of the health system. Sputa pooling with LC-aNAATs is also recommended for faster TB and rifampicin resistance diagnoses. WHO says the strategy can also reduce testing costs.

Nasal

swab test promises early Alzheimer’s detection, Duke Health discovers

A group of scientists from Duke Health have discovered a rapid pathway to diagnosing Alzheimer’s Disease early. Testing includes a nasal swab, according to Duke.

The researchers evaluated the method on 22 participants. What we know about the test:

• It detects Alzheimer’s before the first symptoms appear

• Collection involves a rapid nasal swab to gather nerve and immune cells

• It analyzes active genes and differentiated between healthy patients and those with early and clinical Alzheimer’s “about 81% of the time”

• It alerts researchers to “early shifts in nerve and immune cells”

The test could lead to more personalized treatment and preventive care for Alzheimer’s patients. The researchers are now investigating if the nasal swab test can aid with treatment response surveillance.

Laboratory fraud uncovered

The U.S. Department of Justice’s Office of Public Affairs recently announced the uncovering of a $328 million cardiovascular genetic testing fraud ploy involving former NFL player, Keith J. Gray.

Gray, along with his clinical laboratories Axis Professional Labs LLC (Axis) and Kingdom Health Laboratory LLC (Kingdom), is accused of:

• Spearheading a plot to invoice Medicare for “medically unnecessary genetic tests designed to evaluate the risk of various cardiovascular diseases and conditions.”

• Bribing marketers to share information about Medicare beneficiaries such as their DNA samples, personal information, and unnecessary test orders. Test orders were obtained by the marketers through harassing primary care physicians to approve them. The marketers alleged that the patients in question were previously approved for testing. The “qualification” happened “during telephone calls conducted by non-medical personnel at one of the companies retained by the marketers,” not by the patients’ physicians.

• Using false contracts and invoices and money laundering to cover up the scheme.

Gray was convicted of:

• “Conspiracy to defraud the United States and to pay and receive health care kickbacks

• Five counts of violating the Anti-Kickback Statute

• Three counts of money laundering”

Gray is facing up to a decade in prison per count. A sentence is yet to be made as of March 6, 2026.

Gender differences in cancer outcomes: Insights from a large-scale study

A recent study of more than 20,000 patients with varying cancers found differences in the way cancer effects women over men. The findings are reported in an Adelaide University press release.

The research was performed by Adelaide University scientists and their international partners leveraging records from 39 clinical trials that led to U.S. Food and Drug Administration (FDA) approvals in 2011-2021. Key findings:

• Women had 21% higher longevity than men

• Female patients’ cancers were 16% less likely to progress

• Severe side effects were 12% more common in women These findings were comparable across all 12 cancer types studied, despite the patient’s treatment pathway.

ACS 2026 Colorectal Cancer Statistics highlight alarming increase in younger populations

During National Colorectal Cancer Awareness Month, the American Cancer Society published their Colorectal Cancer Statistics, 2026 report. The findings revealed an alarming increase in colorectal cancer prevalence among younger adults, according to the ACS.

Fewer adults over 65 are being diagnosed with the disease, but colorectal cancer is the top cause of cancer death in patients under 50. The ACS estimates that 200 adults under 65 years of age will be diagnosed per day in 2026.

Additional key findings:

• Rectal cancer and cancers in the distal colon are the most common types of colorectal cancer.

• Many colorectal cancer cases are caused by lifestyle factors like smoking and alcohol.

• Several cases and deaths could be prevented by timely screening and treatment access, ACS says.

• About three-quarters of cases in adults under 50 are already advanced at the point of diagnosis.

• Half of colorectal cancer patients under 50 were eligible for screening at the time of diagnosis.

Strengthening laboratory safety through continuous learning

By Dan Scungio, MLS(ASCP), SLS, CQA (ASQ) and Jason P. Nagy, PhD, MLS (ASCP)CM,QLS

Safety in the laboratory is not a one‑time achievement, it is a practice that must be continu ously reinforced. Skills fade without repetition, procedures lose relevance without updates, and new hazards emerge as technology, workflows, and staffing evolve. To keep pace with these

Earning CEUs

changes, laboratory professionals must engage in ongoing, intentional learn ing. Continuous education in laboratory safety is not simply beneficial; it is the most effective way to ensure teams remain prepared to recognize risks and respond appropriately in an environ ment where conditions shift daily.

See test online at https://ce.mlo-online.com/courses/ Strengthening-laboratory-safety-through-continuouslearning. Passing scores of 70 percent or higher are eligible for 1 contact hour of P.A.C.E. credit.

LEaRning oBJECtiVES

Upon completion of this article, the reader will be able to:

1. List different avenues to obtain safety credits for continuing education (CE).

2. List and describe the various periodicals that are available that can aid laboratorians as an additional source of laboratory safety knowledge.

3. Discuss how safety guidelines are developed using science of safety reasoning.

4. Describe additional certification opportunities that are available to laboratory scientists.

Traditional onboarding alone cannot sustain a culture of safety. New‑hire orientation often compresses essential safety content between facility tours, introductions, and extensive paper work, leaving critical principles diluted or overshadowed. Follow‑up annual modules frequently fail to close the gap—many are generic, repetitive, or disengaging, prompting staff to rush through them with minimal reten tion. For safety to be meaningful and durable, education must be designed as an ongoing, dynamic process rather than a static requirement.

Credits for certification

Continuing education is not just a regulatory box to check for today’s laboratorian—it is an essential com ponent of maintaining competence and accreditation. Medical Laboratory Scientists (MLS) and Medical Labora tory Technicians (MLT) are required by their accrediting bodies to remain current with evolving science, technol ogy, and safety standards.

Scan code to go directly to the CE test.

American Society for Clinical Pathology (ASCP)-certified professionals must renew every 3 years by earning 36 continuing education (CE) credits covering safety, ethics, and discipline specific topics. Similarly, American Medical Technologists (AMT)certified laboratorians follow a three-year cycle but are required to complete 45 CE hours. With busy laboratory schedules and staffing constraints, flexible CE options are essential. Fortunately, laboratorians can obtain CE credits through numerous accessible formats. Attending institutional or healthcare seminars, participating in employer-provided annual training, or completing journal-based learning associated with accredited programs are a great way of attaining credit. These options offer streamlined ways to merge certification maintenance with daily operations. Webinars, however, remain the gold standard for many, offering the on-demand versatility needed to fit into an unpredictable shift.

One of the most widely recognized mechanisms for awarding continuing education credit is the Professional Acknowledgment for Continuing Education (P.A.C.E.) program, administered by the American Society for Clinical Laboratory Science (ASCLS).1 P.A.C.E. serves as the quality assurance framework ensuring that participating programs meet the standards necessary for clinical laboratorians to maintain licensure and certification. P.A.C.E. credits are accepted by ASCP, AMT, and numerous state agencies, making them a reliable path for professionals across the country.

Organizations such as LabCE/MediaLab and ASCP offer a variety of courses that conclude with P.A.C.E credits. Even though there is a price attached, they are still great resources. Both have an extensive online library, ranging from OSHA safety modules to lab-specific safety courses and have methods for participant CEU tracking.

For those looking for a more cost-friendly option, excellent free resources exist as well. The CDC’s OneLab REACH2 program offers a comprehensive library of free CE courses covering safety topics such as chemical fume hood operation, centrifuge safety, bloodborne pathogens, and laboratory risk management. ARUP’s Scientific Resource for Research and Education is another free resource.3 These offerings support laboratory professional education by providing a wide range of online webinars and educational courses, all lead by professionals in their field.

Some webinars and training programs provide P.A.C.E. credits, while others issue general certificates of completion that satisfy most employer-based requirements. These can be highly valuable for laboratory staff and leadership, particularly when continuing education must align with accreditation expectations and support ongoing competency.

Periodicals — Reading like a lab safety professional

Developing a strong safety mindset requires more than annual training— it grows when individuals continually engage with reliable, safety-focused information. One of the most effective (and often free) ways to do this is by subscribing to safety periodicals. These publications help staff stay connected to current issues, emerging risks, and best practices. Some periodicals concentrate on laboratory safety, while others provide a broader view of occupational and environmental health. Even if a publication does not offer continuing education credits, the insights gained can elevate safety awareness and decision-making.

Several well-established periodicals provide valuable perspectives on laboratory and workplace safety (Medical Laboratory Observer is one of them). CAP Today serves as a source for operational and regulatory updates. Its focus on accreditation changes, personnel requirements, and compliance expectations helps laboratories stay aligned with evolving CLIA and CAP standards. For those seeking a deeper understanding of chemical safety, the American Chemical Society (ACS) offers a wealth of technical guidance, research-based commentary, and educational articles on chemical hazards and mitigation strategies. ACS resources (available via their website) are particularly useful for reinforcing safe practices in labs where chemical handling plays a central role. Expanding beyond the laboratory environment, publications such as Occupational Safety & Health (OS&H) and Environmental Health & Safety (EH&S) widen the perspective to include broader aspects of workplace safety. These periodicals frequently highlight OSHA updates, emerging safety technologies, product reviews, training approaches, and analyses of real-world incidents. Their post-incident reviews are especially valuable, encouraging readers to examine root causes and consider how similar risks can be identified and reduced within their own organizations.

The value of these resources extends beyond personal development. Laboratory leaders can easily integrate selected articles into staff education. Assigning short readings for a shift huddle or monthly meeting encourages group discussion and shared learning. Articles that describe significant safety events can be especially impactful, prompting conversations about current preparedness, gaps in practice, and opportunities to reduce risk. By routinely engaging with these periodicals, staff strengthen their safety literacy, stay aware of evolving expectations, and reinforce a culture that prioritizes proactive risk management.

The science of safety

The ongoing learning gained through CE programs and safety-focused publications reinforces knowledge of best practices, but meaningful, lasting safety culture requires more than exposure to information. It requires understanding. To fully internalize and apply safety principles, laboratorians benefit from examining the scientific reasoning that underpins every safety guideline. Beneath every safety rule is a scientific principle that explains why those rules exist in the first place. These principles are rooted in the science of chemistry, microbiology, physics, ergonomics, human behavior, and more. When laboratorians understand the science behind safety, compliance becomes less about obligation and more about informed decision-making.

Consider chemical exposure limits, for example. Occupational exposure limits are not arbitrary numbers selected for convenience; they are derived from toxicological data, dose-response relationships, and epidemiological studies. The same is true for biological safety levels, engineering controls (such as biosafety cabinets), and ventilation requirements. These controls exist because they interrupt known exposure pathways, whether aerosolization, skin absorption, ingestion, or inhalation. Understanding how hazards behave in real-world laboratory conditions allows staff to better recognize risk, even in situations not explicitly covered by a written procedure.

The science of safety also applies to biological hazards. The way microorganisms survive on surfaces, resist disinfectants, or spread through droplets and aerosols directly informs cleaning protocols, PPE selection, and workflow design. Without this knowledge, safety practices can quickly devolve into rote

behaviors that are followed inconsistently or abandoned under time pressure. When laboratorians understand how a pathogen spreads or why a disinfectant requires a specific contact time, they are far more likely to perform the task correctly every time.

Human factors science is another critical component of laboratory safety. Errors are rarely the result of carelessness alone; they are often linked to fatigue, distraction, poorly designed workspaces, or unclear communication. Safety science teaches us that systems must be designed to support human performance, not rely solely on individual vigilance. This perspective shifts the focus from blaming individuals to improving processes, layouts, and workflows that reduce the likelihood of error.

For laboratorians seeking a deeper dive into the origins of safety regulations, formal coursework can be an effective option. Programs such as laboratory safety courses offered through OSHA-authorized education providers explore the regulatory framework developed by the Occupational Safety and Health Administration, explaining how standards evolved in response to real-world incidents, injuries, and exposures. These courses connect regulatory language to practical laboratory applications, helping professionals understand not only what is required, but why it matters.

The science of safety also relies on measurable data that can be translated into action. In the laboratory, safety is not abstract; it can be quantified through tools such as risk assessments, safety audit scores, incident reports, and injury or exposure trends. These metrics provide objective evidence of where hazards exist, how well controls are functioning, and where gaps persist. A risk assessment that identifies repeated exposure potential, an audit score that reveals inconsistent PPE use, or an uptick in sharps injuries are not simply numbers on a spreadsheet; they are indicators that corrective action is needed. When properly analyzed, safety data drives the selection and prioritization of controls (whether engineering, administrative, or behavioral) and helps ensure those controls remain effective over time. Using data in this way reinforces safety as a science-based discipline, grounded in continuous evaluation and improvement rather

than assumptions or anecdotal observations.

Ultimately, the science of safety transforms laboratory safety from a checklist into a mindset. It empowers laboratorians to anticipate hazards, question unsafe practices, and adapt safely when conditions change. In a profession where variables constantly shift—new instruments, emerging pathogens, staffing challenges—this deeper understanding is essential for protecting both laboratory professionals and the patients they serve.

Safety certification

Continuing education is often viewed as a requirement tied to maintaining professional credentials, but safety-focused certification can play a much larger role than meeting renewal criteria. Safety certifications validate a laboratorian’s commitment to understanding risk, regulatory compliance, and best practices that protect people, processes, and facilities. They also signal to employers that safety is not an afterthought, but a professional priority. Targeted safety certifications allow laboratorians to build deeper expertise beyond minimum requirements.

One such option is the Qualification in Laboratory Safety (QLS) offered via ASCP.4 Safety credentials like this focus specifically on laboratory risk management, regulatory interpretation, incident prevention, and safety program evaluation. They are particularly valuable for individuals who serve as safety officers, supervisors, or educators, but they also benefit bench-level staff who want to strengthen their understanding of laboratory hazards.

OSHAcademy’s Laboratory Safety certification program offers a comprehensive, self-paced overview of OSHA laboratory standards, PPE, chemical hygiene, and hazard communication.5 The course content is easy to access, provides 0.4 International Accreditors of Continuing Education and Training (IACET) CEUs, and offers an optional certificate for purchase. For a shorter introductory option, the OSHA Education Center’s Orientation to Laboratory Safety course delivers a one-hour overview of essential safety principles at a low cost and includes a completion certificate.6 These resources offer accessible pathways for staff to deepen their regulatory knowledge, strengthen compliance skills, and better appreciate the scientific

and regulatory foundations that guide safe laboratory practice.

Beyond technical knowledge, safety certifications reinforce leadership skills. Certified safety professionals are often better equipped to conduct risk assessments, investigate incidents, and communicate effectively with both staff and administration. They understand how to translate regulatory language into practical action and how to advocate for safety improvements using data rather than anecdotes. In this way, certification supports not only individual growth, but organizational resilience.

Conclusion

Laboratory safety is not mastered in a single orientation session, annual refresher, or certification cycle. It is a continuous learning journey that evolves alongside science, technology, and workplace realities. Each article read, webinar attended, and course completed adds another layer of understanding, strengthening not only individual performance, but the collective safety culture of the laboratory.

By investing in ongoing safety education, laboratorians move beyond compliance toward competence and confidence. They become better equipped to recognize hazards, question unsafe norms, and contribute to safer systems for their colleagues and patients alike. In a profession built on precision and trust, continuous safety learning is not optional, it is essential.

Dan Scungio, MLS( a SCP), SLS, CQ a ( a SQ) has more than 25 years of experience as a certified medical tech. He was a lab manager for 10 years before becoming the laboratory safety officer for Sentara Healthcare, a system of 12 hospitals and more than 20 labs and draw sites in Virginia and north Caroline. a s “ dan the Lab Safety Man,” he provides consulting, education, and training in the u.S. and Canada.

Jason P. Nagy, PhD, MLS (ASCP) CM ,QLS is the Laboratory Safety Support Coordinator at Sentara Health, a multi-hospital system in Virgina and north Carolina. Jason brings almost 20 years of laboratory experience to the lab as a medical laboratory scientist (MLS) and more recently in laboratory safety and education roles.

References are available online at mlo-online.com/55361396.

Scan code to go directly to the CE test.

When accuracy removes obstacles: The case for interference-free glucose meters

By Cody Maddox, MS-CLS, MLS(ASCP)CM

Over 500 million blood glucose tests are performed in U.S. hospitals every year.1 With the majority of these being done at the point-of-care (POC), accuracy of the devices used is paramount to guarantee the reliability of results and ensure patient safety. A common source of inaccuracy of blood glucose meters is interference from the myriad of medications or supplements that may be administered to support patients.

This is an even bigger issue in critically ill patients, where inaccurate glucose results can lead to devastating consequences for the patient.

Hospitals catering to this fragile patient population are therefore required to provide safe and effective care by equipping their staff with devices that are proven to mitigate these sources

of inaccuracy. In this article, I discuss a case example of a hospital system that changed glucometers based on these considerations.

Policy and workflow burdens created by meter limitations

One of the main drivers for change of glucose meters came from the limitation of the current vendor whose meter was unable to correct for interfering substances such as ascorbic acid, Nacetylcysteine, and hematocrit. Because of the dangerous potential outcomes that have been reported with such interferences, 2-5 our hospital system implemented policies and procedures to avoid using these meters on critically ill patients (see Figure 1). Unfortunately, these policies became cumbersome, confusing, and time consuming. With a

multi-hospital healthcare organization, the various institutions and different levels of care amplified the complexity and burden of these policies. Our organization consists of three full-service hospitals, one emergency-only facility, and one long-term care facility. The main hub institution is a trauma center with all levels of intensive care from neonates to adults. Within the other two hospitals, there are critical care units, acute care units, and pediatric units. The emergency-only facility does not have any inpatient testing and has minimal laboratory testing. The long-term care facility also functions as a specialty hospital with no on-site laboratory testing. Across the organization, there are approximately 4,000 clinical staff certified to perform testing in the POC setting. While the POC program is expansive,

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The following guidelines apply to the use of the glucose meters on “critically ill” patients:

Patients in whom fingerstick sampling is contraindicated:

use is acceptable on venous or arterial samples only:

• systolic BP < 80

• Patient requiring pressor support

• acute decompensated heart failure

• 3+ edema or greater of the upper extremities

• severe DKa or HHns

Patients in whom the glucometer is not approved for use:

use main laboratory method:

• Hematocrit <10 or >65

• triglycerides > 1800 mg/dl

• Galactosemia

• Concurrent iV administration of ascorbic acid or n-acetylcysteine

• umbilical cord samples

the most utilized test is the glucometer. Transitioning to a new glucose meter for such a large number of staff was a large undertaking but was eased substantially with the support of the manufacturer who provided multiple training and support sessions.

Since the previous instrument was unsuitable for critical care patients, a policy was developed to restrict glucometer use in these populations (Figure 1). The policy aimed to limit the potential for false readings on the glucometer. However, the POC staff found it to be extremely challenging to enforce the policy or ensure that the providers and clinical staff were utilizing the instrument properly. If the clinical staff failed to use the policy correctly and the glucometer was used outside of the scope of service, it would push the meter from a CLIA waived test to a laboratory developed test (LDT) and potentially jeopardize patient care. LDTs are subject to significant regulatory restrictions including ongoing, time-consuming validations and caused the organization to re-evaluate their current instrumentation. Patient care would be impacted if these meters were used inappropriately on the wrong patient population since interferences can give rise to erroneously high results that could lead to fatal consequences of excessive insulin dosing, as described at other institutions.2-5

To eliminate the cumbersome policies, there was a need for a meter FDA cleared

for critically ill patients. After evaluating all options, we chose a new glucose meter that was able to correct for the interferences and was FDA cleared for critically ill patients — enabling streamlined workflows, improved clinical accuracy, reduced policy complexity, and enhanced staff efficiency.

Transition process

The transition occurred over several months and included organization-wide training, validation, and implementation. The manufacturer initiated rolling education sessions for staff prior to going live. We started with the smallest hospital to learn best practices and moved progressively larger. The manufacturer validated all meters at one time followed by week-long training at facility 1. During this time, supplies that were necessary for facility 2 were ordered. Training sessions included “train-the-trainer” at the larger sites. There was never more than one hospital per week going live. This allowed time for meetings to discuss the lessons learned that could be applied at the next site. Overall, a progressive go-live with extensive validation and training support from the manufacturer made this an efficient and productive experience.

Technology change boosts POC testing efficiency and confidence

After implementation, we observed several significant improvements to the POC program. As anticipated, we saw improved efficiencies by elimination of the critically ill policy detailed in Figure 1. The new instrument was able to correct for any interferences, and it was FDA cleared for use in any care setting.This allowed clinical staff to obtain rapid results and enable immediate treatment. Hypoglycemic patients could be identified earlier, allowing quicker intervention and more effective care. This ease of appropriate use was very much appreciated compared to reviewing charts to verify the patient does not meet any of the exclusion criteria (hematocrit levels and medication review). It also reduced the number of samples sent to the main laboratory, which improved both patient and clinician satisfaction. Overall, faster treatment times improved patient care as well as throughput goals.

In the five years since transitioning to the new meter, there have been zero physician complaints regarding test results from the new glucose meter.

Figure 1. Critically ill patient criteria.

Figure

Operational and clinical benefits beyond expectations

We were surprised by the improved overall effectiveness of the new glucose meter. The previous meters had a number of electronic error codes that could only be fixed by a trained POC staff member or by replacing the instrument. With those codes, we saw approximately 10–20 instrument replacements monthly across all facilities. Each replacement was associated with time lost and additional efforts in quality control checks for incoming instruments. After implementation of the new interference-free glucometer, we observed a 50–75% reduction in replacements (3–5 per month).This was due to the end user having more access and ability to troubleshoot the instrument at the bedside without needing administrator intervention.

Another surprise benefit involved the manual test entry (MTE) tests. As mentioned above, our organization maintains an expansive POC program with a variety of waived tests on their menu. Some of the waived tests include urine pregnancy, whole blood pregnancy, rapid strep, visual urinalysis, gastric pH, and fecal occult blood. Recording these tests into the electronic medical record required either a form to be filled out or the results could be entered as an MTE into the glucometer, with the latter being more efficient, user friendly, and less error prone. With the previous glucometer only holding a maximum of five manual tests, the organization was restricted from easily capturing and transmitting data from all the necessary POC tests. Since there was no way for some of the tests to be uploaded to the electronic medical record without using an additional form, compliance issues were prominent. We noticed high monthly error rates for manual test entry of POC tests. For example, fingerstick pregnancy error rates were anywhere from 4–13% prior to implementation of the new instrument (Figure 2). Errors included unqualified staff performing tests, recording results, lack of lot number documentation, and improper expiration dates entered. After implementation, we were able to eliminate the external result form and the manual test entry error rate dropped to 0%, where it has remained(Figure 2). Another example was the gastric pH test in the neonatal ICU. The ability to capture 540/month previously undocumented results led to improved traceability and compliance.

The new instrument was able to correct for any interferences, and it was FDA cleared for use in any care setting.

Finally, there was a positive financial impact post transition. Fewer meter replacements reduced strip usage for linearity and quality control. Analyzing a six-month time frame pre- and post-installation, our overall glucose strip usage for quality controls was reduced by 17% in the Intensive Care Unit (ICU) and by 48% in the ICU step-down unit (or Intermediate Care). Similarly, test strips used for linearity were reduced by 33%.

How one technology upgrade improved the POC testing program

This case illustrates that investing in accurate, interference-free technology pays dividends across multiple dimensions of patient care and operations. Overall, transitioning

to the new glucose meter technology delivered measurable improvements across our multi-hospital system, from streamlined workflows and reduced policy burden to higher staff satisfaction, lower costs, and increased compliance. By improving the performance of multiple POC testing workflows, the impact extended well beyond glucose testing.

REFERENCES

1. Klonoff DC, Vigersky RA, Nichols JH, Rice MJ. Timely hospital glucose measurement: Here today, gone tomorrow? Mayo Clin Proc. 2014;89(10):1331-5. doi:10.1016/j.mayocp.2014.08.005.

2. Gaines AR, Pierce LR, Bernhardt PA. Fatal iatrogenic hypoglycemia: Falsely elevated blood glucose readings with a point-of-care meter due to a maltose-containing intravenous immune globulin product. 2008. CBER.

3. Korsatko S, Ellmerer M, Schaupp L, et al. Hypoglycaemic coma due to falsely high point-of-care glucose measurements in an ICU-patient with peritoneal dialysis: A critical incidence report. Intensive Care Med. 2009;35(3):571-2. doi:10.1007/s00134-008-1362-7.

4. Souza SP, Castro MCR, Rodrigues RA, Passos RH, Ianhez LE. False hyperglycemia induced by polivalent immunoglobulins. Transplantation. 2005;80(4):542-543. doi:10.1097/01.tp.0000168752.55185.74.

5. Kirrane BM, Duthie EA, Nelson LS. Unrecognized hypoglycemia due to maltodextrin interference with bedside glucometry. J Med Toxicol. 2009;5(1):20-3. doi:10.1007/BF03160976.

Cody Maddox, MS-CLS, MLS(ASCP)CM is a l aboratory Manager at Grace Medical Center in Baltimore, Maryland. He oversees point-of-care testing for the l ifeBridge Health system in Baltimore. additionally, he serves as an adjunct professor for the Medical l aboratory science program at s tevenson university.

New and current laboratory challenges that impact staffing What you can do to overcome and reach success

By Patty J. Eschliman, MHA, MLS(ASCP)CM, DLMCM, CPC

Laboratories are navigating a period of rapid change, where financial pressures, workforce shortages, and shifting employee expectations intersect in ways that directly affect staffing and operational stability. Policy changes that reduce healthcare funding are placing new strains on laboratory budgets and resources. At the same time, laboratories must adapt to a generational shift in the workforce as experienced professionals retire and Generation Z enters the field with new expectations around technology, workplace culture, and work–life balance. Together, these forces are reshaping how laboratories recruit, retain, and support their teams. Understanding these emerging challenges — and identifying practical strategies to address them — will be essential for laboratory leaders who want to maintain strong staffing, sustain high-quality testing services, and position their organizations for long-term success.

One Big Beautiful Bill

If you have had a chance to dig into H.R.1 OBBB, commonly known as the One Big Beautiful Bill, you may have discovered that it is not so beautiful for healthcare. With over one trillion dollars in cuts to federal healthcare programs, medical laboratories are going to feel the pressure in several ways.

First, the Congressional Budget Office (CBO), a nonpartisan federal agency that provides an independent analysis of budgetary and economic issues, estimates that there will be an increase of 14.2 million uninsured Americans, largely due to reduced affordability and stricter eligibility requirements.1 As Americans lose healthcare access, more uninsured patients delay treatment and end up seeking urgent care in emergency rooms when their conditions worsen. Chronic illness care is both costly and complicated, and lack of compensation creates challenges. Numerous emergency rooms, already stretched thin, will have to provide even more services despite having fewer

resources, a demand that is neither sustainable nor practical.

Second, the bill triggers Medicare sequestration, which reduces federal spending and is estimated to decrease reimbursement to providers by up to $910 billion over the next 10 years.1

Coupled with the increased number of uninsured, decreased reimbursements could lead to staffing cuts, reduced service lines, and financial strains, especially in rural and safety-net facilities. In 2023 and 2024, two major national reference laboratories finalized purchases of eight hospital laboratories. Combined, these two organizations completed 36 hospital lab mergers or acquisitions between 2017 and 2022.2 This could prove problematic for hospital laboratories that are struggling to remain strong financial sources and value-based models for their healthcare systems.

Third, an estimated $880 billion reduction in Medicaid funding over five years is projected to decrease clinical laboratory reimbursement by $3.6 million. Given that rural hospitals

predominantly serve high-Medicaid populations and have limited access to commercial payers to offset these losses, they are expected to face greater financial risk. Not only are reimbursements expected to decline but labs can expect an increase in insurance claim denials, underpayments, and complex billing requirements.4 In this environment, laboratories must pay particular attention to their revenue cycles and ensure they are optimizing their billing practices to align with new payor rules, maximizing every dollar of available reimbursement.

Laboratory staffing challenges overall

Each of these challenges can exacerbate an already significant staffing shortage in the laboratory. If uninsured Americans flood hospital emergency rooms, the pressure for fast, accurate, and complex testing increases. Reimbursement issues mean fewer financial resources to improve technology in the laboratory and keep up with salary demands. Delaying instrument

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purchases stalls technological advances and increases lab frustration as older instruments fail, thus contributing to an already stressful work environment. Additionally, as labs seek automation to address staffing shortages, limited funding can make this approach too expensive. Laboratory staff are among the most highly educated and better paid employees in the healthcare market, causing labor to be the single largest category of hospital spending. In 2024, hospital costs increased by 5.1%, surpassing the overall inflation rate of 2.9%. Keeping up with escalating salary rates remains a considerable challenge. Finally, as staffing gets tight, scheduling in the laboratory can become more rigid. As longer shifts, and fewer working days become more desirable, it takes additional staff to make this possible, especially in a 24/7 working environment.

Meeting the needs of the new workforce

Generation Z, born from 1997 to 2012, will be aged 14–29 in 2026. Many are recent college graduates entering the job market. As Gen Z is entering the workforce, baby boomers are on their way out and this is reshaping staffing, recruitment, and retention in ways that laboratory leaders cannot ignore.

It has been reported that over 22% of Gen Z employees job hop each year with 29% that will completely change fields.

According to research analyst Kristie McDermott, who writes for Maddyness.com, 41% of Gen Zs believe their top strength is their creative ideas, which correlates to 54% of them expecting a promotion annually.6 When not provided, this generation looks elsewhere. But while this might seem like overconfidence to some, other researchers argue that the Gen Z population is often misunderstood. Many younger workers, just over half in the United States, report having a “side hustle” with 62% of them reporting that above all, they value being successful. Gen Zer’s, they say, are merely bored and concerned about burning themselves out doing uninspiring work. Lack of learning new things, uninteresting tasks, and challenges with collaborating are among Gen Z’s most common reasons given for job changes.7 Never has additional training, career ladder opportunities, and cohesive workgroup collaboration been more important in the laboratory.

Don’t forget that this generation was required to learn from home during the pandemic. This may explain their desire

for meaningful work. Gen Z wants to know how their work affects patient care when considering our profession. If the role of a medical laboratory scientist is invisible to most, as is often said of our profession, Gen Z must have laboratory medicine explained in ways that provide meaning, highlight purpose, and explain the lab’s significant contribution to population health.

The Gen Z population also grew up totally immersed in technology. As digital natives, 80% of Gen Z laboratorians expect cutting-edge instrumentation, automation leading to efficient workflows, modern LIS systems, and minimal manual tasks. 91% of Gen Z say that technology would influence their job choices if similar openings were offered. 80% believe that technology and automation create a fair working environment.8 Anything less than automated efficiency would feel like a waste of time and could cause Gen Z workers to lose interest. Herein lies another challenge for laboratories and their need to remain technologically advanced.

Gen Z reports higher rates of anxiety than earlier generations. In the United States, 45% of Gen Z discuss anxiety as a problem compared to 25% of baby boomers.7 This contributes to why this younger generation also values a healthy work–life balance, flexible working models, and a collaborative/friendlier work environment.8 To create flexibility and a greater balance, three 12-hour shifts with a 36-hour work week are often desired over the traditional five-day, eight-hour shifts (40-hour work week), even though it pays less. These longer shifts provide more days off than days on for the employee but can make the challenge of staffing even more difficult. More staff are required when there are fewer staff available to hire. Regardless of these challenges, if you want to hire new Gen Z graduates, this type of scheduling is imperative.

In my own experience interviewing Gen Z applicants, they are asking more questions about team culture and mental health benefits (how many breaks in a day, are the hours flexible, and how many vacation days do they get). Furthermore, questions are asked regarding accountability, the training of supervisors, and their approach to various situations. I don’t see this as a challenge for the laboratory profession but an opportunity. As stated by Nancy Alers MS, MT(ASCP)cm, CQIA, CMQ/ OE, CLC in her interview by MLO Inside the lab of 2026, Insights from 12 laboratory

experts, “The next phase of retention isn’t just about filling vacancies; it’s about cultivating environments that nurture professional growth, well-being, and belonging. If we can achieve that, we’ll not only stabilize our workforce but also elevate the profession as a whole.”9 Way to go Nancy! Creating a caring, inclusive, and accountable workplace is one of our greatest opportunities for laboratory leadership.

Conclusion

In summary, despite ongoing and new challenges that impact laboratory staffing, there are steps laboratories can take to secure future success. First, become a laboratory reimbursement expert or make friends with one. As the complexities for laboratory billing grow, we must all participate in appropriate test utilization, diagnosis coding, and strategies that ensure maximum reimbursement. Next, it’s important to recognize and value the requirements of our team members, particularly those who are recent graduates and part of Generation Z entering the workplace. The demands of this generation, while different than previous, can only improve our workplace and create better working conditions for all of us. As working conditions improve, we can retain the great team members we currently have and attract new ones. The competition, therefore, for limited laboratory professionals, lies in creating a laboratory environment where everyone wants to be. Use your limited resources wisely on automation, improved training, career ladder advancements, and keep a firm hand on a positive and inclusive work culture.

Patty J. Eschliman, MHA, MLS(ASCP) CM , DLMCM , CPC is a Certified Professional Coach who specializes in laboratory leadership growth and professional support. a s President and C eo of The Lab Leader Coach, Patty coaches many lab professionals in all roles in the areas of building leadership skills, preventing burnout, improving communication, building cohesive teams, and how to be a positive influencer. She has 39 years of experience as a Medical Laboratory Scientist, the last 29 spent in leadership.

References are available online at mlo-online.com/55362941.

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How diagnostic stewardship is reshaping the modern lab

Three

years after the pandemic, labs are at a pivotal point as they consider how to leverage their hard-won experiences and increased diagnostic capacity to build new standards for diagnostic excellence.

By Alesia McKeown, PhD

In my role on the Molecular and Scientific Affairs infectious disease team at Roche Diagnostics, I see labs across the country turning this pivot into a powerful opportunity to rethink their processes and ensure every test they run delivers the highest value to the patient. Two lab leaders from the University of Pennsylvania and Seattle Children’s Hospital recently shared how they have shaped their future by improving diagnostic stewardship and onboarding innovative solutions, such as flexible panel design and integrated clinical decision

support tools, to improve patient care and lab efficiency.

At the pandemic’s end, Kyle Rodino, PhD, Assistant Director of the Hospital of the University of Pennsylvania Clinical Microbiology Lab and Director of the newly established Rittenhouse Molecular Infectious Disease Lab, and his colleagues were faced with the opportunity of a high-capacity lab that was no longer processing tens of thousands of COVID-19 tests per week.

“A silver lining of the pandemic is that the Rittenhouse Molecular Infectious

Diseases Lab was born,” Rodino said. “It has equipment, personnel, and the associated infrastructure to do lots of different molecular testing, not just for SARS-CoV-2.”The opportunity was clear, but the puzzle remained: How do you harness this newfound capacity with diagnostic discipline to ensure that every test counts?

This new vision required close collaboration with many stakeholders to ensure the lab continued to serve the most common needs. One of the first actions was to audit lab send-outs,

such as viral-load monitoring for HIV and transplant-related viruses and reclaim testing that could be performed internally.

“Now, you have the same viral load monitoring happening on the same platform by the same laboratory no matter where the patient enters the health system, so we get that longitudinal consistency,” Rodino said.

This centralization of infectious disease testing also freed up other departments to onboard more specialized diagnostics. For instance, the molecular pathology and microbiology teams were able to pursue adoption of new assays on their wish list.

“When we move testing out of a particular area [to Rittenhouse] that is more focused or aligned from a skills perspective with other areas of testing, they can backfill that now with innovative testing they’ve been wanting to do but maybe couldn’t previously because they were at capacity for testing volume and full-time employees,” Rodino shared.

Tackling overuse of testing If onboarding new assays was the “what” of their evolution, diagnostic stewardship was the “how.” Early on, it was clear that real success also meant influencing clinical-ordering behaviors to ensure appropriate use of the available tools.

The team’s focus first turned to respiratory test ordering. A multidisciplinary Respiratory Pathogen Committee was convened to take a deep dive into institutional ordering practices. The committee’s first observation: A significant overuse of expanded respiratory panels was driving up costs without providing equivalent improvements in patient impact.

“The greatest benefit of the expansion of syndromic panels over the last decade has been access to all of these targets, but when you look at some of the panels, seasonality and patient populations, and when you apply them to different use cases, they don’t match perfectly,” said Rodino.

The team suspected that the increased ordering of these panels could be driven in part from heightened respiratory virus vigilance during the pandemic, but this was just part of the story. Now that the respiratory landscape had shifted, new guidance was needed.

The team sought to define a testing strategy rooted in appropriate test use. It referenced multiple resources, including Penn Medicine’s clinical ordering practices, guidance from the

UPenn's Integrated Clinical Decision-Support Tool for Respiratory Test Ordering

≤ 4 targets 20+ targets

f or most patients, the Seasonal Respiratory Virus Profile is the appropriate test. VS.

t he Respiratory Pathogen Profile should be ordered only for specific indications.

repeat testing without clinical worsening and “test-of-care” testing are not recommended.

Source: Penn Medicine

Association for Diagnostics & Laboratory Medicine (ADLM), and insurer medical-policy guidelines.

“We talked about the literature-supported use cases, but also uniqueness of Penn patients — such as how hematology–oncology was using testing for patients actively receiving therapy,” Rodino said.“Then we made a list of five indications that are ‘no-questions-asked’ indications for expanded panel ordering.”

Setting the standard was only the beginning. To achieve true stewardship, the lab had to move beyond the policy and into the clinic, finding the most effective levers to influence clinician behavior and align ordering habits with the new standards. The team considered many of the usual tactics, from provider education to EMR overhauls, and arrived at an integrated clinical decision-support tool that was implemented in September 2024 (see Figure 1).

Now, when providers order an expanded respiratory panel within the EMR, they enter an ordering pathway with a note that explains the institution’s agreed upon use cases. The standard order is a seasonal panel with four or fewer targets whose identities change twice per year. Target selection is informed by regional prevalence and chosen by the Respiratory Pathogen Committee to provide the greatest diagnostic yield of the testing performed. To decrease duplicate testing, the tool also includes a list of results for all recently ordered respiratory testing for the patient.

Accepted clinical indications

• current liquid oncology, hsct or car -t cell therapy recipients

• s olid-organ transplant donor or recipient

• critically ill pediatric patient

• Ic U patients with evidence of pneumonia

• patients with severe underlying respiratory pathology (cop D, ILD)

Beyond the seasonal order, providers also have the option to select the expanded panel. For this selection, providers must specify the clinical need by selecting from a pre-defined menu of five indications. If the patient indication is not included on the list, the provider must provide a free-text description. Importantly, the presence of free text

While every lab may face similar hurdles, the way they go about overcoming them depends on the needs of the populations they serve and the resources at hand.

does not impede the diagnostic-ordering process, as the lab is not monitoring these on a case-by-case basis. Instead, the free-text descriptions are trended over time, and the feedback is used to identify opportunities for indication expansion and further tool optimization. This integrated tool fundamentally shifted ordering habits within the first year. “What we’ve seen is a one-third decrease in the ordering of the large respiratory pathogen panel and a quarter or so of the people who entered the tool reroute themselves to the smaller panel,” Rodino said, noting that reagent spending also decreased by 30%.

Figure 1.

“The Urgent Care Special” Flexible, Targeted Testing to Meet Regional Needs

patient presents with non-specific respiratory symptoms at an urgent care clinic

Not all labs are the same While every lab may face similar hurdles, the way they go about overcoming them depends on the needs of the populations they serve and the resources at hand.

Drew Bell, PhD, Director for Seattle Children’s Hospital’s Clinical Microbiology Lab, was similarly concerned with the post-pandemic overuse of expanded respiratory panels. He tackled this problem through collaboration with the Patient-Centered Laboratory Utilization Guidance Services (PLUGS), a “big engine of laboratory stewardship” within the Seattle Children’s system, Bell describes.

Bell and colleagues identified multiple unique drivers contributing to the increased ordering of expanded panels. Some of the increase was caused by an influx in pediatric admissions diverted from regional hospitals that had recently shuttered or lost their pediatric capacity. In these instances, the increase in test ordering was influenced by multiple external, and largely uncontrollable, factors, but was deemed appropriate for patient management.

The team then turned its focus to the network’s urgent-care clinics. A deep dive into ordering practices at supported urgent care facilities identified that recent surges in Bordetella pertussis and Mycoplasma pneumoniae were primary drivers of expanded panel ordering.“Unfortunately, the way that our system had been built, the only way for our providers to get those answers was with the larger panel,” Bell shared.“If we had the standard flu/RSV/COVID test and the optionality to add on Bordetella

Targeted respiratory virus menu :

Influenza a Influenza B rs V

sars - c oV-2

+ Clinician Ordering Options

Two optional standalone add-ons: B. pertussis M. pneumoniae

or Mycoplasma, that would probably do away with most of the reasons that the larger panel was being ordered.”

In response, the lab established a standalone Bordetella pertussis assay and is actively working on developing a standalone Mycoplasma pneumoniae assay. Once all of these assays are available, the team envisions a future panel colloquially deemed “The Urgent-Care Special,” in which providers can easily request the standard viral four-plex assay with optional additions of the two bacterial targets (See Figure 2).“So if M. pneumoniae is having a bad year in the community, or there’s a Bordetella outbreak in the local public school system, you can collect one swab and run all three tests, no problem,” Bell stated.

Once these options are in place, Bell and team aim to remove the long respiratory panel from the available standard test

menu for Seattle Children’s urgent-care facilities to curb unnecessary use.

As this news has circulated through their clinics, Bell said expanded panel usage has already gone down. This decrease is an indication of the influence that leadership can have on ordering behaviors. “You need to have your leadership on board,” Bell said. “If you change the system technically, that’s usually not enough to change human behavior.Your department leaders have to lead the change you want to see.”

The

future is flexible

When asked about the future, Bell shared that flexibility is a must-have for panel design, optimally allowing for unique responses to constantly shifting pathogens and patient populations.

“The dream panel is always going to be changing depending on what is

Figure 2.

Source: Seattle Children’s Hospital

circulating, how much is circulating, and what the public health risks are at the time,” Bell said. “Also, patient populations change over time, and we want to be reflective of what our patients’ needs are.”

Rodino also believes that the future of diagnostic excellence relies on flexibility.“We would just be using all this testing power in a more responsible way,” he said. “We are approaching a phase two version of syndromic testing in which I would like to apply it in a more judicious manner to all of those different populations and instead of developing one-off LDTs to customize to the right population, testing environment, etc. I would like to use parts and pieces of the same panel where it is most appropriate.”

He sees flexible solutions as the catalyst for a new era of lab medicine, one that accelerates efficiency, transforms the patient journey, and sets a higher standard for care satisfaction.

In an era of rapidly shifting regional needs and evolving clinical complexities, the lab remains a primary driver of healthcare innovation.

In an era of rapidly shifting regional needs and evolving clinical complexities, the lab remains a primary driver of healthcare innovation. As we navigate the complex balance of diagnostic stewardship and innovation, decision-support tools and testing flexibility provide the power to respond to regional needs with precision. The path forward will never be predictable, or perfectly reproducible, but by learning from each other’s breakthroughs, we can transform today’s challenges into a new standard of diagnostic excellence. Let’s lead the way, together.

Alesia McKeown, PhD is a Scientific Partner for Infectious Disease in Medical and Scientific Affairs at Roche Diagnostics . She is the subject matter expert for Roche’s high-throughput and POC respiratory solutions. She also co-leads an interdisciplinary team focused on improving access and utilization of diagnostics in the respiratory disease area.

a-1 Microglobulin

Anti-Streptolysin O

Apolipoproteins: AI, AII, B, CII, CIII, E

b-2 Microglobulin

Complement C3, C4

CRP, hs-CRP

Cystatin C D-Dimer

Haptoglobin

Hemoglobin A1c

IgA, IgG, IgM

Insulin

Krebs von den Lungen-6

Lipoprotein(a)

Microalbumin

Prealbumin

Remnant Lipoprotein

Chol.

Rheumatoid Factor

Transferrin

UIBC

Decision support algorithms that deliver meaningful use in the anatomic pathology lab

By Lisa-Jean Clifford

Artificial intelligence (AI) in anatomic pathology (AP) has moved from exploratory pilots to targeted deployments that meaningfully support diagnosis, quality, and ef ficiency. The labs that see real impact are not deploying AI for its own sake—they are inserting decision support at precise points in the workflow where it improves clinical outcomes, reduces variability, and saves time without adding clicks or additional steps. This article is a practical masterclass on how to design, evaluate, and operationalize AI‑driven decision support in AP so it actually delivers meaningful use.

Identifying meaningful use for your lab

Meaningful use isn’t just model accuracy; it’s clinically relevant gains realized inside the everyday workflow. In AP, that typi cally means the following:

• Earlier review of cases that have been identified as hav ing a high probability of being positive through triage and worklist prioritization

• Greater diagnostic consistency with standardized fea ture detection and quantitative scoring

• Fewer misses and near‑misses via region of interest (ROI) highlighting and secondary checks

• Faster reporting through structured extraction and synoptic assistance

• Higher throughput without burnout—minutes saved per case, fewer re‑cuts, less manual interaction

To be meaningful, the AI must produce actionable outputs

— stat or priority identification; ROIs; probability estimates; and calculations that pathologists trust and can easily accept, adjust, or override.

Where decision support algorithms add real value

Case triage and worklist prioritization

AI models can assign a probability of malignancy or clinically significant findings and push those cases to the top of the pathologist’s worklist. In high‑volume subspecialties, such as prostate, breast core biopsies, colorectal resections, triage helps ensure that urgent cases are read earlier, often shaving hours off time‑to‑initial‑review. The key to this use case is lab defined thresholds and the ability for the pathologist to override or re prioritize when confidence is low.

Region‑of‑interest identification and heatmaps

Whole‑slide image (WSI) algorithms can identify likely tumors, mitotic cells, necrosis, perineural invasion, or lym phovascular invasion. These findings help pathologists focus attention where it matters and reduce the risk of oversight, especially in tedious, large‑section specimens. ROI overlays should be togglable and be able to be stored with the case.

Quantitative biomarker support

For immunohistochemistry and in situ hybridization, AI can count positive cells, compute H‑scores, quantify percentage positivity, and assist with HER2, ER/PR, Ki‑67, PD‑L1, and

others. Even when the final call remains with the pathologist, quantitative consistency reduces inter‑observer variability and turnaround times while increasing efficiency and accuracy.

Quality control and pre‑analytic checks

Slide quality factors such as focus, tissue folds, artifacts stain intensity, and scanner anomalies can be flagged early to avoid wasted time on case routing to pathologists only to have to be sent back for re cuts or re scans, delaying the diagnosis. Pre‑analytic decision support is invisible when it works— fewer interruptions and smoother downstream throughput.

Synoptic and narrative assistance

Natural language processing (NLP) models can extract key facts from dictated text or draft synoptic templates for ease of the pathologist’s confirmation. The win isn’t creative writing — it’s completeness — no missing fields, consistency in ter‑ minology, and speed to final report. Guardrails, structured prompts, and image management system (IMS) or laboratory information system (LIS) integration are essential to prevent irregularities and to support the full benefit of automation.

The compelling factor of success

AP data is messy because elements vary by scanner, stain, protocol, and site. Strong foundations for algorithms include the following:

• Representative training sets that span multiple stains, scanners, magnifications, tissue types, and disease prevalence. AP models trained on one scanner and stain protocol often degrade and require additional training and validation when applied across additional ones.

• Region‑level annotations are required for tasks like mitosis detection and tumor identification and segmentation.

• Metadata discipline: Capture scanner model/firmware, stain protocol, batch/lot, magnification, tissue type, and timestamps. This is essential for drift detec tion and recalibration and for root‑cause analysis in anomaly detection.

• Standardization: Make sure that algorithms have nor malized stains, are using consistent terminology, and define tile extraction logic consistently.

• De‑identification and security: Clear data governance, audit trails, and access controls ensure compliance and defensibility during algorithm development, tuning, and validation.

Treat your lab data like the valuable asset that it is—invest once in cleaned, labeled, well‑documented datasets and leverage that for additional revenue streams across mul tiple use cases.

Not just accuracy: Understand the value or success metric for adoption

Identify what your operational objectives are for deploying algorithms. Is it to improve patient care, increase operational efficiency, improve turnaround times, impact diagnostic ac curacy or other? Pre‑determine the measurements of your success thresholds by defining what you consider clinically meaningful improvements, plus operational metrics (minutes saved per case, reduction in re‑cuts, fewer disparate reads). You will want to capture these data points before implemen tation so that you can measure your improvement and ROI post implementation. I recommend measuring at 3 months, 6 months, and 12 months post go live to see your immediate and your longer term realized gains. It will also be eye opening

to see how increased use and experience improves the ROI as time increases.

Another good metric to gather is measuring agreement with pathologist reads, turnaround time impact, and override patterns. This will help determine its actual value in practical, clinical applications.

Interoperability and true integration: The makeor-break factor for successful adoption

The fastest way to kill adoption is to force more manual steps in a pathologist’s workflow. It also opens the opportunity for human error and mixing patient cases and AI output if you are working in multiple screens and applications. Successful adoption, and results, happens when your AI algorithms are directly integrated within your digital platform or IMS. This is how the pathologist has access to all of the information that is related to that specific patient and case in a single, unified solution and workflow. It ensures that AI results appear auto matically on the whole slide image. This also supports that AI outputs (ROIs, measurements, calculations) are stored with the case and are traceable in the audit trail. This also supports the pathologist’s ability to accept, alter, or reject the algorithm’s results in their diagnosis. Again, tracking this information is key to determining the efficacy and value of the algorithm in your lab’s usage. If a feature or function adds clicks or dictates the decision, it’s not decision support—it’s decision obstruction and not very palatable to most pathologists and labs.

There are also several applications for AI in terms of the point of inflection for the algorithm. These should all be con sidered when determining the overall value and goals for your adoption and usage. First read is when there are preset rules for which cases the algorithm will automatically be applied to prior to routing to the pathologist. This workflow allows for the results to be available to the pathologist when they open the case and view the slide. There is also ROI application where the pathologist can determine if, and when, to apply an algorithm and to which areas on the image in real time. And second read or QC is when the algorithm is applied post diagnosis as an automated QC process and follows the percentage that you determine needs to go through a second read in your organization. Each application is valuable and has its own benefits, and costs.

Be sure to pair hard metrics with user sentiment. Does the AI make pathologists more confident? Increase turnaround times? Improve accuracy? Reduce corrected cases? Adoption depends on both and often they are not a 50/50 result.

Conclusion

AI‑driven decision support in AP labs is most powerful when it reduces tedious, time consuming and manual tasks. When it is tightly integrated in your digital platform and provides beneficial outputs for the pathologist. When you deploy al gorithms in a planned, measured and meaningful way, the gains compound—better patient care, happier pathologists, and a lab that can scale its expertise with an increasingly resource constrained workforce.

Lisa-Jean Clifford is the President at Gestalt Diagnostics She is recognized as an industry expert and actively participates on numerous boards including the a ssociation of Pathology informatics where she serves as President and mlo ’s Editorial a dvisory Board. She is widely published in many top laboratory publications and noteworthy news sources, such as Forbes, ca P today, medical l aboratory observer, and health data management.

UHealth Laboratories, University of Miami Health System

Performance-driven culture anchored by skilled, safety-focused professionals

By Christina Wichmann

Medical Laboratory Observer ’s 2026 Lab of the Year is UHealth Laboratories, the enterprise laboratory for the University of Miami Health System. There are 18 UHealth Laboratories, including hospital-based; ambulatory centers; the Sylvester Comprehensive Cancer Center and its satellites; research laboratories; and advanced specialty facilities, such as the Bascom Palmer Eye Institute. 630 full-time equivalent staff are employed by UHealth Laboratories, where last year, 2,324,726 tests were performed in clinical pathology, anatomic pathology, and blood bank/ transfusion services.

UHealth is South Florida’s only university-based medical system. In this academic ecosystem, UHealth Laboratories supports inpatient, emergency, and highly specialized medical care. The laboratory also provides 24/7 clinical consultation support to one of the nation’s largest transplant programs (500+ solid organ transplants a year). The immunology and histocompatibility laboratory provides transplant immunology testing, including high-resolution next-generation sequencing/human leukocyte antigen typing, crossmatch, antibody testing, chimerism, transplant virology, immune monitoring, and mass spectrometry therapeutic drug monitoring.

MLO’s Lab of the Year issue is our most anticipated of the year, and each year, we receive many notable nominations.

Laboratories are judged on achievements across five categories: customer service, productivity, teamwork, education and training, and strategic outlook.

The many achievements of UHealth Laboratories underscores its importance within a health system committed to innovation, discovery, and service to the region’s diverse communities.

Customer service

Customer service at UHealth Laboratories is centered on delivering a reliable, patient-focused diagnostic experience supported by consistent communication, operational transparency, and close partnership with clinical teams. UHealth’s service model is designed to provide patients and providers with timely access, dependable turnaround time and results, and a courteous, professional experience. Specific examples that demonstrate UHealth’s commitment to customer service are as follows:

• Patient feedback is used to refine the service experience. The Outpatient Lab Likelihood to Recommend analysis for January through December 2025 demonstrated strong performance, with 5,575 total responses and a “very likely to recommend” score of 87%. 91% of patients reported positive interpersonal interactions

Uhealth Laboratories’ leadership team

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and 83% expressed confidence in the laboratory’s ability to meet their needs. Analysis of patient feedback also identified opportunities for improvement, particularly in communication domains such as listening carefully, explaining next steps, and clarifying information. Comments within the survey also indicated opportunities to improve wait-time consistency and the functional layout of certain outpatient draw stations. These insights will inform targeted improvement actions and align with the system’s commitment to listening to patient voices and addressing concerns proactively.

• Over the past two years, UHealth has executed one of the most significant access and infrastructure expansions in its history— opening UHealth Doral (November 18, 2024) and UHealth SoLé Mia (September 30, 2025). These ambulatory facilities were designed and built by UHealth to expand access to academic medicine, and each incorporates dedicated laboratory space that supports modern workflows and enterprise-wide standardization. These new laboratories are equipped with state-of-the-art analyzers, automation platforms, and smart-specimen workflows. To strengthen access and service coverage, UHealth expanded its draw-station footprint with eight new phlebotomy chairs at UHealth Doral and nine chairs at UHealth SoLé Mia, increasing same-day laboratory access and pre-analytical capacity for the surrounding communities.

ensure that the laboratory system maintains reliable turnaround times, even as testing volumes continue to grow. All workflows are mapped, documented, and maintained in PolicyStat and are regularly reviewed to enable teams to identify and correct inefficiencies and align processes with best practices. Specific examples that demonstrate UHealth’s commitment to productivity are as follows:

• Customer service for clinicians is provided through predictable turnaround times, consistent communication, and integrated digital tools. The use of EPIC, Sunquest, CoPath, SoftLab, and real-time dashboards helps providers access results efficiently, monitor specimen status, and request additional testing without delays. Laboratory teams maintain direct lines of communication with emergency medicine, oncology, surgery, and ambulatory clinics, ensuring that urgent needs, critical values, and add-on requests are managed promptly. The courier network, operating across all sites, supports the reliable movement of specimens to ensure consistent service across the system.

• Operational reliability further strengthens customer service. Laboratory teams coordinate continuously between hospital-based labs, ambulatory centers, oncology satellites, and specialized facilities to maintain service stability under changing operational conditions. When workload surges or instrumentation challenges arise, sites support one another through workload redistribution, back-up testing, and coordinated courier movement. This enterprise connectivity sustains a high-performing laboratory system where seamless service delivery for patients and providers is maintained.

Productivity

Productivity is supported by standardized processes, disciplined operational oversight, continuous improvement, and facility modernization. A commitment to eliminating waste, reducing variation, and strengthening the flow of services across the laboratory network guide daily operations and

• Productivity is monitored through dashboards developed by UHealth staff that extract real-time data from EPIC, Sunquest, CoPath, SoftLab, RedCap, RL6, and Visiun. These dashboards support daily decisionmaking and allow leaders to manage turnaround times, volumes, workload distribution, pre-analytical performance, equipment uptime, and accuracy metrics across all areas of Clinical Pathology, Anatomic Pathology, Blood Bank, and Phlebotomy. Monthly reviews evaluate financial indicators, quality measures, delay metrics, TAT performance, safety incidents, and compliance outcomes such as proficiency testing, contributing to a comprehensive oversight structure.

• Performance monitoring is embedded into routine laboratory operations through dashboards, executive reviews, departmental meetings, operational huddles, and one-on-one performance discussions. This structured oversight enables rapid identification of trends, timely intervention, and continuous recalibration of priorities. Integrating real-time data with a comprehensive performance management structure ensures that UHealth Laboratories maintains operational discipline, supports data-driven decisions, and advances strategic objectives.

• Multiple sites are undergoing analyzer upgrades to transition from legacy systems to newer Roche Cobas solutions, including Cobas Pure and Cobas Pro platforms. These upgrades enhance throughput, reduce maintenance interruptions, improve standardization, and support more predictable operations across Plantation, Deerfield Beach, Coral Gables, Hollywood, Fort Lauderdale, Coral Springs, and select Miami sites.

• Phlebotomy improved wait-time performance even as patient visits surpassed 165,000 annually, and Clinical Pathology sustained rapid turnaround times despite increases in volume. The expansion and modernization

c

Phlebotomist and patient

of physical laboratory spaces have been a key driver in this productivity. At UHealth Doral, the laboratory footprint now includes more than 1,600 square feet dedicated to Clinical Pathology, more than 360 square feet for Anatomic Pathology, and more than 500 square feet for the expanded draw station. Similarly, at UHealth SoLé Mia, more than 1,700 square feet support Clinical Pathology operations, more than 500 square feet support Anatomic Pathology, and over 1,000 square feet are dedicated to phlebotomy and patient access.

Teamwork

Teamwork is central to UHealth’s success in delivering diagnostic services across a large and geographically distributed network. Daily operational huddles allow frontline staff and supervisors to review workflow priorities, staffing considerations, equipment readiness, and emerging issues, creating a consistent forum where staff can coordinate efforts and ensure alignment throughout the day. Issues requiring escalation are captured through RedCap, which provides an efficient and transparent mechanism to document concerns, trigger timely leader follow-up, and support the resolution of recurring issues through root-cause analysis. This closed-loop approach promotes a culture of psychological safety, responsiveness, and shared ownership of operational reliability. Examples of UHealth’s positive teamwork culture are as follows:

• The Powered by You systemwide engagement survey reinforces teamwork by providing structured opportunities to assess team dynamics, communication

effectiveness, clarity of direction, support resources, and overall work environment across all laboratory sites. The survey evaluates multiple dimensions of engagement, including teamwork and collaboration, employee empowerment, manager relationship, clarity of expectations, continuous improvement, well-being, recognition, and diversity and inclusion. After each survey cycle, results are carefully reviewed with staff, allowing teams to explore the meaning behind the responses, identify root causes, and jointly select priority areas for improvement. Action plans are developed collaboratively, focusing on specific behaviors, resources, or processes that strengthen team cohesion and operational reliability. These plans are then implemented and monitored over time, with leaders recognizing progress, reinforcing positive outcomes, and making adjustments when necessary.

• Transparency plays an important role in UHealth’s culture. Operational dashboards displaying test volumes, turnaround times, quality indicators, safety events, staffing metrics, and performance trends provide all staff with access to the same information, encouraging shared responsibility for results and continuous improvement. Monthly leadership reviews bring together managers and supervisors from all UHealth Laboratories’ sites to evaluate performance, compare trends, and coordinate enterprise-level adjustments. These discussions help unify the network, encourage problem-sharing and solution-building, and ensure that decisions reflect the realities of each location.

• Teamwork is also strengthened by regular interactions such as case consultations, technical discussions, and cross-training among Anatomic Pathology, Clinical Pathology, Blood Bank, and Immunology and Histocompatibility Laboratory teams. These interactions deepen understanding of shared processes, interdependencies, and the collective impact of laboratory performance on clinical care. Additionally, collaborative

relationships with clinical units, nursing teams, emergency services, oncology clinics, and transplant programs ensure that laboratory operations remain aligned with clinical needs and patient care priorities.

Education and training

Education and training are foundational to sustaining a highly competent, safetydriven workforce. UHealth Laboratories has a comprehensive and structured

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education framework designed to develop a highly competent workforce capable of supporting safe, timely, and accurate diagnostic services across all UHealth locations. Education and training activities follow a unified, systemwide model that ensures consistency in onboarding, competency validation, and ongoing skill development. Examples of UHealth Laboratories’ educational approach are as follows:

• Newly hired staff complete standardized orientation and technical onboarding pathways supported by learning maps tailored for each role. These learning maps guide employees through essential knowledge, laboratory practices, system navigation, quality expectations, safety protocols, and their progression toward independent performance. This structured approach ensures early alignment with UHealth’s standards for safe, high-quality diagnostic work.

• Competency assessments are conducted routinely throughout the year across all specialties, ensuring continued proficiency in phlebotomy, testing procedures, safety practices, and instrument operation. The entire operation is supported by a standardized documentation system, PolicyStat, which provides employees with immediate access to job-specific procedures, policies, competency materials, and reference information. This centralized system contributes to consistent practice across all sites and supports compliance with CLIA and accreditation requirements.

• Continuing education is provided through UHealth’s enterprise platforms, including ULearn and LinkedIn Learning, which provide access to structured coursework, curated modules, and specialized technical content aligned with individual development needs. A culture of continuous learning is further supported through an annual “Continuous Improvement” goal required of all employees. This goal prompts each staff member to identify and pursue targeted opportunities to expand knowledge, strengthen technical and interpersonal skills, and refine behaviors that contribute to departmental performance and service excellence.

• Ongoing education is embedded in daily operations through morning huddles, technical case discussions, leadership rounding, quality reviews, and peer-to-peer mentoring. These mechanisms create real-time learning moments, promote knowledge transfer between experienced and new staff, and support rapid dissemination of updates related to workflows, safety alerts, or technology implementations.

• Leadership development is a central pillar of the educational framework. Supervisors and managers participate in structured leadership training designed to strengthen communication, coaching, standard work oversight, accountability, and problem-solving. As part of this initiative, UHealth Laboratories is implementing a Training Within Industry (TWI)–based program for supervisors. The program builds capability through job instruction, job methods, job relations, and job safety. These modules provide leaders with the skills to teach tasks effectively, analyze workflows, maintain constructive employee relationships, and uphold safe work practices.

Strategic outlook

UHealth Laboratories operates under a unified enterprise strategy that aligns with the University of Miami Health System’s mission to deliver highquality academic medicine, expand access throughout South Florida, and strengthen integration between

clinical care, research, and education. The strategic direction centers on creating a standardized, high-reliability diagnostic network across all laboratory locations — hospital-based laboratories, ambulatory centers, oncology satellites, specialty laboratories, and transplant services — supported through centralized governance, operational alignment, and a robust quality management infrastructure. Elements of UHealth Laboratories’ strategic plan are as follows:

• The strategic plan is guided by system values summarized by the acronym DIRECCT: Diversity, Integrity, Responsibility, Excellence, Compassion, Creativity, and Teamwork. These values inform expectations for professional conduct, collaboration, and decision-making across the laboratory system. Complementing these values are UHealth’s service standards — safety, caring, responsiveness, and professionalism — which shape the way all team members interact with patients, providers, and colleagues.

• The core pillars of the laboratory strategic plan include growth, operational excellence, quality and compliance, and patient care. Growth focuses on expanding UHealth’s diagnostic footprint by incorporating new technologies, developing advanced test methods, and increasing community access through sites such as Doral and SoLé Mia. Operational excellence prioritizes performance improvement, workflow optimization, digital innovation, and staffing models that support predictable

turnaround times and efficient resource utilization. Quality and compliance emphasize systemwide standardization, continuous readiness, and rigorous accreditation standards across all CLIAcertified sites. Patient care centers on delivering accurate, timely, and actionable results that support clinical decision-making in all service areas, including emergency care, oncology, specialty medicine, and transplant services.

• Once strategic goals are established, they are deployed systematically across all levels of the organization. Executive leadership sets systemwide objectives, and each laboratory location and functional area aligns its annual initiatives with the broader strategic agenda, ensuring that all team members understand their role in achieving enterprise goals. Communication of the strategy and progress updates occur through leadership forums, intranet channels, educational platforms, and unit-based meetings, ensuring transparency and alignment across the network. This structured deployment model reinforces accountability and supports consistent execution across a geographically distributed system.

Closing

UHealth Laboratories exemplifies how a large, complex diagnostic network can operate with consistency, innovation, and a strong commitment to patientcentered care. Across hospital laboratories, ambulatory centers, oncology sites, and specialty facilities, the organization demonstrates how operational discipline, data-driven decision-making, and continuous education works to support high-quality clinical outcomes. At the heart of this success are laboratory professionals that embrace collaboration, accountability, and service to the communities of South Florida. As Associate Vice President Paola Pagan noted, “Receiving the Medical Laboratory Observer Laboratory of the Year recognition is a tremendous honor for UHealth Laboratories and a reflection of the dedication of nearly 600 laboratory professionals who support patient care across our health system every day. Our focus has been on building a unified, high-reliability laboratory network that strengthens clinical decision-making and improves patient outcomes.”

c ourtesy of U h ealth Laboratories

technologist at microscope

2026 Lab of the Year Runner Up Atrium Health Cabarrus Laboratory

By Erin Brady

Atrium Health Cabarrus Laboratory is one of the recipients of Medical Laboratory Observer’s 2026 Lab of the Year Runner Up Awards! They are located in Concord, NC, with 65 full-time equivalents and 457 licensed beds. The lab includes core laboratory testing, transfusion services, anatomic pathology, histology, some microbiology, and serology.

Atrium Health’s purpose statement says, “From discovery to everyday moments, we are redefining care- for you, for us, for all.”1

Continuous improvement

Continuous improvement has been an ongoing endeavor at Atrium Health Cabarrus. This approach has resulted in increased productivity and efficiency, faster turnaround times, and reliable results.

“We are so proud of the spirit of dedication exemplified by our teammates

each and every day,” said Ryan Romano, DO, Laboratory Medical Director, Atrium Health Cabarrus, Harrisburg and Kannapolis. “Working together within the laboratory, with departments throughout the hospital and with community partners, the focus our teammates direct towards quality patient care and improving the health and lives of those we serve truly sets the standard. It is humbling to see them recognized for the extraordinary work they do and a privilege to work alongside them.”

Nursing collaboration

In an effort to enhance patient safety across the health system, Atrium Health’s Cabarrus Laboratory partnered with the hospital’s nursing department. Through this collaboration, the lab developed educational tools for the nursing department demonstrating how to properly label tubes. They presented a poster at the 2025 Patient

Safety fair that included an engaging game called “Stick the label on the tube” with candy incentives. They also:

• Emphasized the significance of the Positive Patient Identification process and why it should be utilized for every test.

• Educated nursing staff on the impact of hemolysis, low volume specimens (including blood cultures), contamination, order of draw, and clotted specimens. Expanding on the laboratory-nursing partnership, the departments, along with Beckman Coulter held a Process Improvement (PI) event that lasted two days, focusing on specimen collection best practices. Prior to the event, the health system was experiencing diagnostic delays and workflow inefficiencies due to pre-analytical specimen collection defects such as mislabeling specimens, hemolysis, clotted and QNS specimens, PPID overrides, differences

atrium health cabarrus Laboratory team and executive Leadership.

in workflows and knowledge across departments, and restricted shared data access.

During the event, the Specimen Collection PI Workgroup was developed, and the following changes were implemented, according to the lab:

• Taking inventory of the existing reports

• Requests for enhanced SlicerDicer and custom reporting

• Shared nursing/lab dashboards were created

• 24/7 defect tracking was put into place

• Objective prioritization

• Consistent workflows

• Frontline teams are provided with feedback in real-time

• Targeted PDSA cycles for highimpact defect categories

This workgroup is now actively engaged facility-wide, driving to a goal of 30% decline over 90 days in specimen collection defects.

Dwight R. Roache, DHA, MHA, FACHE, Vice President, Operations at Atrium Health – Cabarrus said, “At Cabarrus, our Lab truly embodies a culture of continuous improvement. What impresses me most is their commitment to transparency and shared

data, not as a reporting exercise, but as a catalyst for real change. A great example is the multidisciplinary specimen collection workgroup they built with Nursing. By standardizing workflows and using shared dashboards to pinpoint defect trends in real time, they reduced recurrent issues like mislabeled specimens and QNS rates. That level of collaboration has strengthened reliability across the entire care continuum and meaningfully improved outcomes for our patients.”

Automation

Atrium Health Cabarrus launched the Automation Workflow Group in 2025. The group consists of lab technicians and lab assistants, allowing them to share recommendations and take action to enhance operations. The lab also actively communicates with their automation system vendor, Beckman Coulter, to continuously improve automation in the lab.

When Atrium Health Cabarrus adopted a new automation system, they took the time to educate their nursing partners on the new process, emphasizing the significance of collecting high-quality specimens to generate the best results. The lab filmed a video and created educational flyers to support automation training.

Fostering the next generation of lab professionals

Staffing shortages have been burdening clinical labs nationwide. Atrium Health has been working to get high school and college students interested in the field through community outreach. In 2025, they:

• Presented at three career fairs

• Awarded scholarships and hospital work opportunities

• Hired student interns

• Provided students with “lunch and learn” sessions

• Gave students lab tours and shadowing opportunities

• Participated in the HYPE Summer Academy, a shadow and internship program for high school students

• Participated in the PATCH career panel, a healthcare profession pathway program

Improving health

In 2025, Atrium Health Cabarrus Lab achieved a safety improvement: efficiently eliminating a radiological

security and regulatory risk. They partnered with Sandia National Laboratories/Off-Site Source Recovery Program (OSRP) to remove a highrisk cesium-137 blood irradiator. To replace it, Atrium Health Cabarrus adopted RadSource’s RS 3400 X-ray irradiator, a technology that is non-radioactive and approved by the Food and Drug administration (FDA). The new technology was implemented with no interference with transfusions.

Atrium Health Cabarrus would like to thank the following organizations for their contributions to this accomplishment:

• Sandia Laboratories

• Office of Radiological Security (ORS)

• LANL

• RadSource

Only 13 counties in North Carolina offer prehospital blood transfusions, and Atrium Health Cabarrus is now one of them. They partnered with Cabarrus County EMS to launch this regulatory compliant program, giving trauma patients a higher chance of survival. They are able to provide these services without reducing the hospital’s blood supply.

Conclusion

Atrium Health Cabarrus Laboratory’s dedication to continuous improvement, education, and community outreach made them stand out during MLO’s 2026 Lab of the Year running. Gary Catarella, MBA MT(ASCP), Vice President of Operations, Atrium Health North Carolina & Georgia Divisions gave the following statement regarding the lab’s achievements.“The Atrium Health Cabarrus Lab team exemplifies what it means to deliver excellence in laboratory medicine. Their commitment to patient safety, innovation, quality, and collaboration sets a powerful standard for our laboratory. This recognition as a 2026 Lab of the Year runner-up recipient is a testament to their dedication, leadership, and the meaningful impact they make every day for the patients we serve.”

REFERENCE

1. About Us. Atrium Health. Accessed March 10, 2026. https://atriumhealth.org/ about-us#our-care-continum.

2026 Lab of the Year Runner Up Inova Blood Donor

Services

By Erin Brady

Inova Blood Donor Services (IBDS) is one of the recipients of Medical Laboratory Observer’s 2026 Lab of the Year Runner

Up Awards! They are located in Sterling, VA and serve more than 8 million patients. They administered more than 550,000 tests in 2025, with only eight techs. The laboratory and donation center work hand in hand to deliver quality and compassionate care. IBDS’ resilience and commitment to patient care made them stand out during the Lab of the Year running.

“Being recognized by MLO as a Lab Runner Up is a great honor for Inova Blood Donor Services and a testament to the critical role our laboratory plays within Inova’s hospital-based blood center,” said Sean McCleary, Vice President, Professional Services, Inova Health System.

“Our team is uniquely positioned to test and process donated blood with an unwavering focus on quality and safety, ensuring a safe, pure and potent blood supply for patients across Inova and our healthcare partners throughout the Washington, DC metropolitan region. This recognition reflects the dedication of our laboratory professionals and their commitment to delivering reliable, lifesaving blood products every day.”

An uninterrupted supply chain

that they experienced an “uninterrupted supply chain” in 2025 due to the efforts of their staff and 50,513 donors. They ensure all blood products are compliant with the Food and Drug Administration (FDA) and the Association for the Advancement of Blood & Biotherapies (AABB).

“For IBDS, regulatory compliance is inseparable from patient outcomes,” commented Darryl Elzie, PsyD, MHA, MLS (ASCP), CQA (ASQ) B+, Manager, Regulatory Affairs, Inova Blood Donor Services. “Every SOP, validation study, and quality review ultimately supports safe transfusion practices across our health system and the region we serve as whole. Being named the MLO’s 2026 Runner-up validates that our regulatory framework is not only vigorously compliant, but it is operationally effective and mission driven.”

Through a collaboration with emergency responders, Inova is able to provide type O blood to emergency vehicles so patients can receive prehospital care, particularly those that live in rural areas. 73,640 blood products, including 49,104 red blood cells were distributed to Inova patients in 2025.

Inova’s purpose is “to provide a safe, pure, potent and adequate blood supply for patients in the diverse communities we serve.”1 This starts with their 98.93% fill rate for orders and 739 blood drives conducted in 2025. Inova told MLO

Nicholas Lilly, MBA, B+, Senior Director, Inova Blood Donor Services said, “As a hospital-based blood center that supports a large health care provider in the DC area, we rely on obtaining test results for donations within 24 hours of collection so that we may get those products to patients as soon as possible. We are so fortunate to have a high-quality team of Laboratory Professionals that perform amazing work

iBDs LaB and Quality team 2026. c ourtesy of i nova Blood Donor s ervices

day in and day out; without our Lab Team, we would not be able to ensure that our products are pure, potent and safe.”

Overcoming storage challenges

IBDS average 2025 Sigma score for operational efficiency was above 3.83, despite two walk-in refrigerators and two walk-in freezers failing. They were rebuilt ahead of schedule without consequential disruption to hospital and EMS services. IBDS would like to thank the following vendors for their work on the walk-ins:

• Diversified Laboratory Repair

• Calloway Contracting Group

• Architecture Incorporated

• First on Site

Testing

Based on federal requirements, the following equipment is used at IBDS:

• Alinity s for HB core antibody, HB surface antigen, HCV antibody, HTLV ½ antibody, HIV 1/2/Group O antibody, and Chagas antibody.Panther for HBV, HIV, and HCV Nucleic acid testing.

• Erytra for ABORH, antibody screen, and red cell phenotyping.

• Neo Iris for ABORH, antibody screen, antibody identification, antibody titer testing, and red cell phenotyping.

• Gemini for HLA Class I & II antibody.

• BacT/Alert for bacterial detection of platelets.

• ABX Micros 60 hematology analyzer.

• Adam HT for rWBC.

• Basic Array Imaging System for molecular red cell genotyping.

All IBDS professionals who process tests are American Society for Clinical Pathology (ASCP) or American Medical Technologists (AMT) certified.

To track the quality of their testing, the lab implemented two continuous quality monitors, Instrument Maintenance Logs and Clerical Errors. Since adopting the new technology, the lab has experienced lower clerical errors.

Additionally, IBDS enhanced its testing portfolio in 2025 by:

• Validating the EZ2 Connect platform for PreciseType HEA molecular-bead-chip testing

• Enabling advanced red cell genotyping to support complex transfusion scenarios and patients with higher alloimmunization risk

• Validating replacement and additional Procleix Panther and Procleix Xpress (v4.0) systems

• Achieving nucleic acid testing (NAT) capacity and resilience against instrument downtime without interruption

• Authorizing six portable point-of-care hematology analyzers (PixCell HemoScreen) for mobile blood drive access

Teamwork — making an impact

In addition to making blood testing more accessible through their mobile initiatives, the IBDS team worked to have Prehospital Transfusion Whole Blood (PHTWB) added to the National Defense Authorization Act. They sent their Medical Director and Regulatory Affairs Manager to appeal to Congress in 2025 and advocated for the program to be brought to Virginia. The program includes 30 EMS and air-medical units across Virginia.

Excellent teamwork is the foundation of IBDS’ success in providing impactful patient care. Their team of 105 consists of Donor Specialists, Medical Laboratory Scientists, Medical Laboratory Technicians, Hospital Services, Quality Assurance, Materials Management, Center Collection, a Mobile Operations Team, an Administrative Team, the Information Technology Support Team, and the Blood Bank Team. Impressively, IBDS dropped their employee turnover rate by more than 6% in 2025, making turnover less than 15%.

Along with the achievements mentioned throughout this article, the IBDS team’s efforts in 2025 resulted in:

• Satisfactory proficiency testing results the whole year

• Continuous compliance with AABB and FDA standards

• More than 5,000 hours of training completed to enhance donor services, apheresis, POCT hematology, quality operations, and regulatory compliance

• The introduction of cold-stored platelets

• Pathogen reduction

Srilatha Jayavarapu O+, Laboratory Services Manager at Inova Blood Donor Services emphasized, “Commitment to patient care is all that drives the discipline, hard work, persistence and decisions for me and my team.”

REFERENCE

1. Our Objective. Inova. Accessed March 11, 2026. https://www.inovablood.org/about-us/our-objective/.

Preparing samples for testing at iBDs

Blood components prepared for shipping out to hospitals.

Modern carrier screening requires a streamlined approach

By Ninad Pendse

One of the biggest changes in women’s healthcare recently has come from the field of carrier screening.

Once a niche offering focused on just a few genes for women of specific ancestries, carrier screening has become far more common — and more complex — thanks to updated clinical guidelines that broadened recommendations for who should be tested. The goal of these new recommendations, improving healthcare equity across all women, is admirable. But on the technical front, the result for clinical labs can be quite a burden.

The updated carrier screening guidelines did not just add to the pool of women who should receive testing; these guidelines also added substantially to the list of genes that should be included in the screening process. There are now more than 100 genes recommended for carrier screening. That list includes a number of genes known to be difficult or even impossible to resolve with the short-read sequencing technologies that have become nearly ubiquitous in clinical laboratories.

Clinical lab teams have scrambled to answer the call for expanded carrier screening, often by implementing a variety of technologies to resolve the difficult genes. Carrier screening for a single person might involve four, five, six, or more workflows to generate reliable results about all of the recommended genes. This kind of complexity is simply not

tenable for a screening process that might be appropriate for every pregnant woman and all women considering becoming pregnant. Long-read sequencing technologies offer a more practical approach, allowing lab staff to implement two straightforward workflows — one for the difficult genes, and one for everything else. This technique can simplify carrier screening and lower the barrier to adding carrier screening as a routine capability in clinical labs.

The evolution of carrier screening

The early days of carrier screening took place 50 years ago, beginning with ancestry-based guidelines, such as testing for Tay-Sachs disease in people of Ashkenazi Jewish descent. Over time, these recommendations turned into a patchwork that has been difficult for physicians to keep up with. The approach also suffered from limitations in how much patients know about their own genetic ancestry; people who should have gotten screening based on guidelines could easily be missed with the reliance on self-reporting. For a long time, the only genetic conditions for which carrier screening was advised regardless of ancestry were spinal muscular atrophy and cystic fibrosis.

In 2021, the American College of Medical Genetics and Genomics (ACMG) set out to improve equity with a new,

universal set of recommendations for carrier screening. The updated ACMG guidelines standardized the list of genes that should be screened — a total of 113 genes, including 16 X-linked genes and 97 autosomal recessive genes — and recommended the same level of screening for almost all women.1 The guidelines also allow for screening additional genes based on the needs of specific populations or families.

For most clinical labs, the leap from the handful of genes previously included in standard carrier screens to a panel of 113 genes is enormous. But it’s also important. The previous approach to carrier screening allowed too many women to fall through the cracks and failed to test for genetic conditions relevant to each patient. The expanded ACMG gene list represents an effort to bring standardization to carrier screening and to ensure a base level of care for all women who need this valuable test.

Intractable genes

Unfortunately, being important does not translate to being easy. In its report presenting the new guidelines, the ACMG acknowledged that many of the genes included in the recommendations would be burdensome for clinical labs.“Another challenge is for the molecular testing laboratories to adapt new testing strategies since some of the ACMG Tier 3 genes may harbor variants that are not routinely detected by NGS only,” the authors wrote.1

While most of the 113 genes can be resolved easily enough with short-read tools, about a dozen genes defy characterization. Some examples include the CGG repeat expansion in FMR1 that’s responsible for fragile X syndrome; F8, which can have large inversions in an intron that lead to severe hemophilia A; the GBA gene associated with Gaucher disease, which has a nearly identical pseudogene in GBAP1; and CFTR for cystic fibrosis, a gene that harbors large exon deletions or duplications.

From structural variants that are too large and complex for standard NGS platforms to pseudogenes with high homology to genes targeted by carrier screening, the group of challenging genes requires lab staff to get creative. They usually end up with a number of different technologies: qPCR, long-range PCR, PCR/CE, and Sanger sequencing are all common. Even multiplex ligation-dependent probe amplification, a tedious and cumbersome technique, is often implemented to help with some of these troublesome genes.

Streamline with long-read sequencing

With so many niche technologies deployed to address each gene’s specific challenges, carrier screening can be far too complex for most clinical labs to offer. But long-read sequencing offers a solution to this problem.

While the dozen or so intractable genes are intractable for different reasons, all of the technical issues they present can be overcome with long-read sequencing data. Highly homologous sequence, GC-rich repeat regions, large structural elements — all of these suddenly become tractable simply by having reads long enough to fully span the difficult region with enough flanking sequence to allow for proper alignment. There are a few long-read sequencing technologies available, with read lengths ranging from kilobases to hundreds of kilobases. By pairing these long reads with sufficient depth of coverage, it is now feasible to resolve even the most difficult genes in the human genome.

In addition, long-read sequencing data allows users to phase variants. As a result, clinical lab teams can read out maternal and paternal alleles, with the ability to assign

mutations to the correct allele for situations where genome interpretation may differ when two mutations in a gene are on the same allele or on different alleles.

While long-read sequencing can be used for all of the ACMG-recommended genes, it is likely more cost-effective to continue sequencing the easy genes on short-read platforms. Consolidating all of the difficult genes onto a single long-read platform streamlines the carrier screening process, allowing labs to implement just two reliable workflows for the full set of genes.

Incorporating a new long-read sequencing platform may seem impossible for clinical labs with scarce resources.

ACMG’s updated carrier screening guidelines represent much-needed progress in improving health equity and standardizing an important healthcare tool — but they also dramatically increased the complexity of this screening process for clinical lab teams.

While some platforms require high capital expenditures up front, there are options that don’t. Nanopore sequencing, for example, does not have the same cost structure as other sequencing platforms, so it may be a more affordable option.

Moving forward

ACMG’s updated carrier screening guidelines represent much-needed progress in improving health equity and standardizing an important healthcare tool — but they also dramatically increased the complexity of this screening process for clinical lab teams. Being able to offer carrier screening for all pregnant women, plus all women who plan to become pregnant, means that labs must have robust and streamlined workflows capable of resolving all 113 recommended genes. Current approaches using many different technologies to process the most challenging genes require too much hands-on time and involve more complexity than is desirable for such a frequently ordered test.

A better approach reduces that complexity to a simple dual workflow: standard short-read sequencing for the hundred or so easy genes, plus a single long-read sequencing assay covering all of the tough genes. This model minimizes manual intervention and delivers results more reliably than the patchwork method used by many labs today. For a healthcare need as important as carrier screening, that’s a truly meaningful improvement.

REFERENCE

1. Gregg AR, Aarabi M, Klugman S, Leach NT, et al. Screening for autosomal recessive and X-linked conditions during pregnancy and preconception: a practice resource of the American College of Medical Genetics and Genomics (ACMG). Genet Med. 2021 Oct;23(10):1793-1806. doi: 10.1038/s41436-021-01203-z.

Ninad Pendse serves as senior product manager for molecular diagnostic products at Asuragen, a Bio-techne brand.

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LABORATORY INNOVATOR

Aaron K. Odegard, MS, MLS(ASCP)CM , SMCM , QLSCM is a laboratory quality coordinator at Baptist Health Jacksonville. In addition, he is an adjunct assistant professor in the Department of Medical Laboratory Sciences at the University of Arkansas for Medical Sciences and Santa Fe College. He received his master’s degree in biomedical sciences— molecular pharmacology and experimental therapeutics from Mayo Graduate School of Biomedical Sciences.

Aaron is passionate about medical laboratory science and serves as a member of both the ASCP Commissions on Membership and Continuing Professional Development. He is a founding member of the LAB-CARES Team. He enjoys educating fellow professionals, students, and the public on laboratory leadership, mentorship, and medical laboratory sciences through several platforms. Outside the laboratory, he likes to curl, travel, and hike.

How do you plan to celebrate Medical Laboratory Professionals week this year?

Medical Laboratory Professionals Week is a time to celebrate our laboratory team outside and inside the laboratory. At Baptist Health, this is a time for reflection and connection with all our team members across five hospitals and five free-standing ER laboratories. I have the privilege of coordinating medical laboratory professional’s week across the entire health system. This is our time to shine and advocate. Our mayor provides an official city proclamation. I work with our hospital communications team to have physical and digital banners across the hospitals. The hospital communication team also features the laboratory on

Celebrating the lab: Aaron Odegard

By Christina Wichmann

the hospital social media channels. The hematology laboratory usually makes a themed video to share on the last day. Each day, different laboratory departments are featured at tables in the main hospital. The tables contain information, interactive activities, and photographic props for educating patients and other departments.

We coordinate with vendors to provide Lunch & Learns. We have hospital system-wide games and contests daily. There will be a lab coat decorating contest this year. Outside the laboratory, we have several activities for team members to come together. There are two 5K “runs” at different areas of the city. We have matching shirts and engage with the surrounding community as we “run” the 5K. These end with food gatherings. We’ll also have a painting with a twist party. People bring food and drinks. Laboratory team members get to be creative and catch up outside of our service to patients.

How is automation reshaping

laboratory workflows in your experience?

I have the unique perspective of coming into the clinical microbiology laboratory right before automation. We were still utilizing phenotypic biochemicals while starting to integrate automation. This gave me a strong foundation and allowed me to develop more critical problem-solving skills. Direct specimen testing, rapid identifications, automated specimen processing is allowing the clinical laboratory care team to work more efficiently. However, we still need to instill the importance of basic laboratory skills and resilience in our new medical laboratory professionals. As seasoned professionals, we have to continue to mentor and build these skills in the next generation. There will be times when automation is down. They can’t freeze. They have to have the skills to keep going because we still have to be able to serve our patients.

How do you prepare your team for an accreditation survey?

“Quality means doing it right when no one is looking.” The Quality Assurance (QA) team instills this value in all of our

laboratory team. All team members are involved in preparing for an accreditation survey. Each department has a weekly audit of a different department (fresh eyes in each department). We make sure that team members report nonconforming events and good catches. The goal is to build a culture of safety. Our QA department has monthly visits at each hospital and department. We review safety, proficiency testing, staff competency, and any other issues. We provide monthly audit reports and best practices. Team members are given the opportunity to participate in our self-inspection process. We also participate in external peer inspections. Different team members are able to go and learn more about the inspection process, bring back best practices, and develop their accreditation skills. All these practices have been beneficial in excelling in our accreditation surveys.

What strategies have you found most effective in mentoring emerging laboratory professionals?

Emerging laboratory professionals value connection, purpose, and professional development. I start out by diving into the importance of each team member’s role in the laboratory. We have an enrichment week. The emerging laboratory professionals get to learn about various leadership roles inside and outside the laboratory, including LIS, QA, industry partners, and more. We attend hospitalwide safety huddles. This gives them a more comprehensive picture of the role of the laboratory care team. I give them some time to reflect. We meet a week later to discuss and outline some goals. I’m a mentor but also a sponsor. I advocate for the mentee and provide them with the same opportunities I was given by others. This can be partnering on a verification study to discussing a microbiology culture. Mentorship can be as simply as a five-minute conversation. I’ve also cotaught microbiology courses to provide a mentee the opportunity to gain teaching experience and provide access to opportunities.You have to keep in mind this is a long-term investment. Plant the seeds for trees you’ll never see.