News
Clinical laboratories are key to breaking down the healthcare barriers faced by transgender patients
Clinical laboratories could significantly improve health care for the transgender community by using both sex and gender identity to make decisions about clinical testing, and by determining normal lab values for healthy transgender patients.
A review published in Clinical Chemistry journal emphasizes critical steps on the road to eliminating the many hurdles that transgender individuals face when seeking quality healthcare. The survey found that 25%-30% of transgender people delay or avoid health care due to fear of discrimination, 15%-20% have been refused care by medical professionals, and 25%-30% have experienced harassment or violence in a healthcare setting.
Some of the recommended best practices for clinical laboratories to help ensure that transgender patients receive equitable care:
- Labs can base decisions on a patient's birth sex and gender identity.
- When sex-specific tests such as those for PSA or pregnancy are seemingly ordered for a patient of the opposite sex, labs should not cancel these tests and should always properly flag the results.
- Labs should develop precise reference intervals for transgender patients taking hormone therapy.
Increased workload for Saskatchewan medical technicians jeopardizing health care
The Canadian Union of Public Employees (CUPE) released a report on the working conditions of medical technologists this week.
The report, titled Under Pressure, was based on an online survey the union conducted last fall. The results paint a dire picture, revealing a stressed-out, exhausted workforce, who are concerned their working conditions are hurting patient care. The number of medical laboratory technicians has dropped by 7 per cent since 2012. Yet, Saskatchewan's population has grown by 6 per cent between 2011 and 2016. Respondents want more staff. The majority (65%) said they think having replacements for vacation and sick leave would help the problem. More than half (56%) said the minimum amount of staff should increase. The report clearly shows a decline in technicians' health. Exhaustion was a common theme. One reported going "home exhausted and in a fog because I barely have time to think about what I am doing."
CUPE recommends in the report the government consult with front-line staff and take an audit of vacant staff positions and how many medical technicians are needed. The union wants the government to share the results of this audit with them. It also wants the government to give more money to hire medical technologists and technicians and revise its health human resources plan to prepare for the existing and upcoming shortage of technicians.
Video Testimonial: Shaelynn, CLXT
Leadership
Millennials: Demystifying this new generation of leaders
Historians William Strauss and Neil Howe defined millennials as the group born between 1984 and 2004. Some say the group has an inflated sense of entitlement, that millennials are job hoppers, and that they don’t want to work hard. Others note that they are resourceful and tech-savvy.
Increasingly, millennials are finding themselves in leadership roles, which means the narrative is changing. Yet little is known about how the leadership styles of millennials compared to leaders of other generations. That was the motivation behind a report released earlier this year by RW2 Enterprises in conjunction with Development Dimensions International and The Conference Board which compared the values and preferences of millennial leaders and non-millennial leaders at various organizations. A few key generational differences were uncovered. The data showed that millennials are more ambitious about their careers and expect advancement at an accelerated pace. Millennials also find coaching from managers, internal coaches, and mentors more effective. And more than other generations, millennials value achievement and fun. Read more to hear about the differences between generations and their management styles.
Studies show utilization management systems help clinical laboratories remove physician uncertainty over availability of diagnostic tests and how to properly interpret results
By using dedicated systems to define proper lab test usage, track lab orders and patient outcomes, and share data between clinical laboratory and healthcare environments, health care professionals can seamlessly access the knowledge needed to improve decision making. An important opportunity exists for laboratory experts to further improve the understanding of the ever-shifting menu of testing options and how to best utilize available lab services.
A published study noted that among 32,000 primary care physicians surveyed: 7% were uncertain about which diagnostic tests to order; 3% were uncertain on how to interpret results; and respondents only consulted with pathology or laboratory experts 6% of the time.
Another published study highlighted how combining expert laboratory advice with a dedicated electronic laboratory utilization management system (ELUMS) might shape the future of testing and help educate healthcare providers. The authors compared testing costs before and after implementing an ELUMS. They attributed six-figure savings to a reduction in high-volume large-panel testing and redundant tests.
The Kaiser Health News report also noted the impact of Choosing Wisely at Cedars-Sinai hospital. The hospital avoided $6-million in spending in 2013 by implementing program recommendations, and by being more selective regarding tests and procedures utilized at the hospital.
The Trials of Implementing Lab Automation Systems: Key Lessons from University of Chicago Medical Center’s Experience
The University of Chicago Medical Center (UCMC) clinical chemistry laboratory recently implemented a new laboratory automation system and learned several lessons that may be of value to other labs.
- The new system needed to be installed in the existing space as the old system without any disruption to testing (multiple phases - decontaminating, uninstalling, and removing the old system and then installing and validating the new instruments).
- There was unplanned construction work. Sometimes structural, electrical, or water damage didn't become apparent until the older instruments have been removed.
- Problems arise particularly when the manufacturer’s security solution is not compatible with the institution’s network, software, and hardware security protocols.
- In just 4 weeks, they installed, validated, analyzed, and reviewed 150 assays. In anticipation of this, almost 6 months before installation began the lab identified and started biobanking unique specimens (very high or low analyte concentration and/or low testing volume).
Microbiology
Australian researchers employ POC RNA testing to address growing rate of HCV infections
Hepatitis C virus RNA testing at the point of care (POC) could provide an advantage over antibody testing by enabling diagnosis of active infection in a single visit, according to a recent study conducted by researchers in Australia.
A published study evaluated the performance of the Cepheid Xpert HCV Viral Load assay at the point of care at five sites in Australia. The sites included three drug and alcohol clinics, one service for the homeless, and one needle and syringe program. The researchers found that the assay detected active infection with levels of specificity and sensitivity comparable to that of a popular laboratory test, the Abbott RealTime HCV Viral Load assay. Researchers found that sensitivity of the Xpert HCV Viral Load assay for HCV RNA detection in samples collected by finger-stick was 95.5 percent, and specificity was 98.1 percent, and they verified that the viral load test can effectively detect active infection from a finger-stick sample. Continue reading more about HCV testing in this article.
Molecular Genetics
Make DNA tests routine, says UK's chief medical officer
Genomic testing should become a normal part of NHS care, beginning with cancer patients and those with rare diseases, says the chief medical officer, Dame Sally Davies.
In her annual report, Davies stresses her enthusiasm for the genomic revolution which could transform the treatment that NHS patients receive. Drugs can be matched to the disease and to the patient to maximise the benefit and reduce side-effects. "The age of precision medicine is now and the NHS must act fast to keep its place at the forefront of global science," said Davies. "This technology has the potential to change medicine forever – but we need all NHS staff, patients and the public to recognise and embrace its huge potential. Genomic medicine has huge implications for the understanding and treatment of rare diseases, cancer and infections." Amongst her recommendations, Davies calls for a National Genomics Board to be set up, and chaired by a government minister. All genomic laboratories should be centralised and a national network established to provide equal access across the country, she says.
Research
Humans could be vaccinated against heroin, after successful trials In monkeys
A vaccine that could be used to treat heroin addicts could be on the way, after successful trials in primates. The vaccine, which has been developed at the Scripps Research Institute (TSRI), blocks the "high" of heroin, and has been shown to be effective up to eight months after being administered. This is the first vaccine against an opioid to pass this stage of testing, and the researchers hope that they will now be approved to move on to clinical testing.
It works by teaching the immune system to produce antibodies against heroin, and the psychoactive products within it that cause the high users experience. The vaccine does this by exposing the immune system to part of the heroin molecule's structure. Then when heroin is next introduced into the system, the newly created antibodies will target it, neutralizing the heroin molecules. Users (in this trial, rhesus monkeys) don't feel the euphoria from heroin, because the heroin molecules are blocked before they can reach the brain. This published research looked at heroin only, and wouldn't be effective against other opioids. However the same logic can be applied, and a previous study by TSRI showed that a vaccine for "designer drug" Fentanyl was effective in mice.
Ethics
Lab technician fired for looking up, revealing colleague's pregnancy test results
In New Zealand, a medical laboratory technician has been found guilty of professional misconduct after accessing the laboratory records of a colleague and sharing the information with other colleagues. The practitioner and medical laboratory scientist had been discussing whether another colleague might be pregnant because she requested time off for a blood test. The practitioner then accessed the woman's laboratory records on the work computer and found that she was waiting on results for an ante-natal screen blood test. The practitioner then told a number of staff about the tests saying, "Guess who's pregnant?" Despite being warned against it, the practitioner accessed the woman's records again the next day and told colleagues about the results.
The Health Practitioners Disciplinary Tribunal agreed her actions amounted to professional misconduct so she was censured, ordered to pay $6300 in costs, required to disclose the decision for a year after she resumed work as a lab technician and that she attend a course on ethics, privacy and confidentiality if she did resume work in the industry.
Concerned about ethical behaviour in the workplace? Review the CSMLS Code of Ethics today!
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