Rcc Design Video University Lectures Online Free
Acute pancreatitis presents with abdominal pain, nausea, and vomiting, while chronic pancreatitis presents with abdominal pain, diarrhea, and weight loss. Unfortunately, these clinical symptoms are not specific for pancreatic diseases, so laboratory testing and imaging are essential in making a diagnosis. An approach to laboratory testing for diagnosis, prognosis, and guidance of management of these diseases will be discussed, as well as important clinical features, pathophysiology, and risk factors.
Granulomas are aggregates of macrophages, often admixed with other inflammatory cells, which usually result from chronic antigen presentation. Many diseases that produce granulomas involve the liver. Some are intrinsic hepatic diseases, whereas others are disseminated systemic diseases that involve the liver as well as other organs. This lecture emphasizes infectious causes of granulomas, but also discusses non-infectious entities in the differential diagnosis.
The general surgical pathologist may encounter medical renal pathology in the course of daily work, including in the assessment of the non-neoplastic component of kidney resections for tumor, in the frozen section assessment of donor kidney biopsies prior to transplantation, and in the workup of the autopsy kidney. In this lecture, the goal is to highlight the most important associated renal pathology issues, and to cover practical aspects related to these three particular clinico-pathological scenarios.
The presentation summarizes what we know thus far about the pathology of vaping-related lung injury. There are only a few pathologic studies on the types of lung damage that occur in vaping and the differences between these and smoking-related changes. We will discuss the striking histologic differences in lung injury caused by these two dangerous inhalational exposures.
This presentation will cover fun, bizarre cases in Parasitology. We will discuss the route of infection for various foodborne parasites and the clinical presentation of zoonotic parasites.
Downward reimbursement pressure and a need for cash is leading to the sale of hospital outreach programs. This is a short-term solution that provides the health system with an infusion of cash but takes away the long-term benefits and revenue potential that comes from investing in the laboratory. With proper planning, it is possible to reclaim outreach business that has been sold, as demonstrated by Tucson Medical Center.
This presentation will focus on supervised machine learning and automated machine learning within the healthcare disciplines. The presenter will show studies which demonstrate how such platforms guide translational studies in various clinical context.
The purpose of this presentation is to highlight, in a case-based format, four important scenarios all pathologists who routinely examine breast specimens should be aware of to avoid common pitfalls in the histopathologic diagnosis and biomarker interpretation of suspected breast cancers and their mimics.
This presentation provides an overview of the types of tumor markers and their utility in breast cancer. Statistical characteristics of tumor markers such as sensitivity and specificity will be reviewed. The diagnostic and screening modalities for breast cancer will be described. A detailed discussion on the use of tissue- and serum-based tumor markers will illustrate the importance of tumor marker testing in deciding therapeutic agents, monitoring treatment, and detecting early recurrence in breast cancer. Finally, the challenges faced by clinical chemistry laboratories in testing for serum-based tumor markers will be discussed.
HER2 gene (aka ERBB2) amplification is directly related to HER2 protein overexpression in human breast carcinomas. This somatically acquired genetic alteration is associated with shorter disease-free and overall survival of patients in the absence of HER2-targeted therapy. Because HER2-targeted therapies have significantly improved outcomes for patients whose cancers have this alteration, accurate assessment of the alteration with companion diagnostics is considered critically important. US Food and Drug Administration (FDA)-approved companion diagnostics assess either HER2 gene amplification using fluorescence in situ hybridization (FISH) or HER2 protein overexpression using immunohistochemistry (IHC) assays. In an effort to standardize evaluations of HER2 status, the American Society of Clinical Oncology (ASCO) and the College of American Pathologists (CAP) have convened committees to establish guidelines for assessment of HER2 status. These guidelines were published in 2007, 2013 / 2014, and 2018. Although HER2 IHC assays have challenges, with both false-negative and false-positive results, these assays are easily performed and easily interpreted. Each set of the guidelines consider IHC to be a suitable method for assessment of HER2 status, except in the IHC 2+ category, which is considered "equivocal" with supplementary testing recommended using FISH for definitive assignment to a "HER2-positive" or "HER2-negative" designation. The interpretative approaches to assessment of HER2 gene amplification by FISH recommended by the ASCO-CAP guidelines have changed over the years with current guidelines designating 5 different groups according to HER2 FISH ratio and average HER2 gene copy number per tumor cell. The ASCO-CAP FISH groups are "group 1," designated in situ hybridization (ISH)–positive, has a HER2-to-chromosome 17 centromere (CEP17) ratio ≥2.0 and an average HER2 gene copy number per tumor cell ≥4.0; FISH "group 2," formerly (2013) designated as "ISH-positive", has cancer cells with HER2-to-CEP17 ratio ≥2.0 but an average HER2 gene copy number per tumor cell <4.0; FISH "group 3," also formerly designated as "ISH-positive", has cancer cells with HER2-to-CEP17 ratio <2.0 and an average HER2 gene copy number per tumor cell ≥6.0; FISH "group 4", formerly and currently designated as "ISH-equivocal", has cancer cells with HER2-to-CEP17 ratio <2.0 and an average HER2 gene copy number per tumor cell ≥4.0 but <6.0; FISH "group 5", designated as ISH-negative, has cancer cells with HER2-to-CEP17 ratio <2.0 and an average HER2 gene copy number per tumor cell <4.0. At the time when these FISH guidelines were initially published, there were no studies using this interpretative strategy and, therefore, no available data related to prevalence rates of each FISH group, correlation of each FISH group with HER2 protein expression, or correlation of each group with clinical outcomes, either with or without HER2-targeted therapies. Since their publication in 2013 / 2014 we, and others, have assessed these prevalence rates and correlations. These findings, some supporting and some contradicting the guidelines, will be summarized in the presentation.
This presentation will review how molecular testing results impact the clinical care of breast cancer patients from the perspective of a medical oncologist. Topics will include options for gene expression profiling to determine adjuvant therapy in ER-positive breast cancer, predictive biomarkers in metastatic breast cancer including PIK3CA, ESR1, PD-L1, and BRCA1/2, and implications of borderline HER2 results.
The Introduction to Clinical Cytogenetics course is designed to provide a broad background in the study of chromosome structure, function, and variation, and how this knowledge is applied to clinical testing. This lecture will cover basic biology concepts, including cell division, gametogenesis, and genomic imprinting, as well as common cytogenetic terms such as mosaicism, chimerism, among others. The foundations of karyotype testing will be presented, as well as the nomenclature used to describe chromosomes and their abnormalities.
The Introduction to Clinical Cytogenetics lecture 2 will explore the many forms of chromosome structural rearrangements observed in cytogenetic studies, their nomenclature notation, and their relationship with health and disease in both the constitutional and cancer settings. Advanced concepts in oncology karyotype nomenclature will be presented to facilitate the recognition of tumor clonal diversity and complex karyotype interpretation.
The Introduction to Clinical Cytogenetics lecture 3 will expand on the list of chromosome tests used in the clinic. An in-depth description of fluorescence in situ hybridization (FISH) will be presented, including the major FISH probe strategies, nomenclature, and applications. Chromosome microarray will be presented, together with a description of technical processing, analysis, and applications in constitutional and cancer studies.
This presentation will focus on the newly proposed Milan System for Reporting Salivary Gland Cytopathology. The categories, diagnostic criteria, associated risks of malignancy, and typical clinical management will all be discussed. The role of ancillary testing in refining diagnoses will also be addressed.
Neoadjuvant therapy is an important treatment option in an increasing number of patients with breast cancer. Accurate initial histopathologic diagnosis and biomarker assessment of breast cancers are critical in the identification and treatment of appropriate candidates for presurgical systemic therapy. Precise assessment and reporting of post-treatment breast specimens are essential to provide the most relevant information for the multidisciplinary treatment team to care for these patients. This presentation will review the clinical indications for neoadjuvant therapy and the role of the pathologist in this treatment pathway. How the Residual Cancer Burden (RCB) and AJCC Classification systems compare when used in the reporting of post-treatment breast specimens will be addressed.
The spindle cell lesion represents a large and diagnostically diverse group among soft tissue tumors. In this presentation we will examine the role of cytology, core needle biopsy, and ancillary techniques that allow for a specific classification when possible. We will discuss general principles of soft tissue pathology and practice using eight interesting spindle cell core biopsy case examples.
This presentation will look at the different prenatal screening tests that are offered for early detection of open neural tube defects, trisomy 21, trisomy 18, and trisomy 13. The 1st trimester combined screen and 2nd trimester quadruple screens will be examined in detail, focusing on their methodology, performance, and interpretation of results. Non-invasive prenatal testing, chorionic villus sampling, and amniocentesis will also be presented.
Patient blood management (PBM) involves optimizing anemia and hemostasis with the goal of avoiding unnecessary transfusions. It improves patient outcomes, reduces costs, and is considered standard of care. Sanguine is a novel, rapidly flexible data visualization tool for evaluation of PBM practices in meaningful clinical contexts.
This presentation will cover the basic diagnosis of CLL/SLL. Additionally, recommended testing and a review the effects of targeted therapies on various assays will be discussed.
Hemolytic anemias due to abnormalities of the erythrocyte membrane comprise an important group of inherited disorders. These include hereditary spherocytosis (HS), hereditary elliptocytosis (HE) and hereditary pyropoikilocytosis (HPP) and hereditary stomatocytosis. These disorders are characterized by clinical, laboratory and genetic heterogeneity. HS is the most common inherited anemia in individuals of northern American descent affecting approximately 1 in 1000-2500 individuals depending on the diagnostic criteria. The clinical heterogeneity of these disorders range from in-utero transfusion to well compensated anemia. This presentation will address the different types of RBC membrane disorders, and its pathophysiology. Diagnostic techniques including utility of next generation sequencing (NGS) will also be discussed.
Although the development of alloantibodies can cause significant morbidity and mortality in transfusion-dependent patients, the immunological processes the govern the development of alloantibodies following transfusion and the consequences of alloantibody formation are not completely understood. 1This lecture will examine key immune factors that regulate the development of alloantibodies following blood transfusion, while also assessing important factors that influence the consequences of alloantibodies on incompatible blood transfusion.
Pure spindle cell lesions of the breast are both rare and diagnostically challenging. This presentation will compare the clinical, radiologic and immunohistologic features of malignant and benign spindle cell lesions of the breast, including some case examples where the distinction is particularly difficult and important.
Inflammatory lesions of the breast pose diagnostic and treatment dilemmas given their rare prevalence, unclear etiology, chronic symptoms, dispersed care among different physician subspecialties, and sometimes confusing medical literature on the topic. However, pathologists can play a key role in helping affected patients by educating clinicians on the differential diagnosis, advocating for proper tissue culture, and furthering the field of study on breast microbiota.
A case based presentation will be used to discuss the differential diagnosis of basaloid head and neck tumors. Particular emphasis will be placed on salivary gland tumors and HPV-associated carcinomas.
This presentation will cover some entities that require genetic testing for precise diagnosis and classification, as opposed to cases where the diagnosis is based only on morphology and immunophenotype.
This presentation provides an in depth discussion of current prognosis and staging criteria for oral cavity tumors and oropharyngeal tumors, specifically focusing on how HPV infection status, depth of invasion, and extranodal extension may alter the staging of these tumors and the subsequent treatment. The presentation also lists common treatment options for oral cavity cancer and oropharyngeal tumors, covering robotic surgical techniques, chemo and radiation therapies, and the potential benefits of immunotherapy.
Ethanol is one of the most widely used drugs in the world and excessive ethanol use can lead to abuse and alcohol dependence. Alcoholism is the leading cause of morbidity and mortality in the U.S and the 3rd leading cause of preventable death. Testing for alcohol exposure is important to manage the health of patients with alcohol use disorders, to detect individuals driving under the influence, assess patient adherence in drug and alcohol abstinence programs, evaluate fetal risk for neonatal alcohol exposure during pregnancy, and for prequalification screening for organ transplantation surgery.
This presentation will provide an understanding of the fundamental concepts of method/assay verification and validation. Which studies are required by CLIA regulations based on waved versus nonwaived test categorization will be defined, as well as best laboratory practices for meeting each of the requirements. Practical application of these concepts will be demonstrated using a recent example of an assay that was implemented at University Hospital laboratory.
Recognizing that there can be significant morphologic overlap between soft tissue entities is important and often humbling. This lecture will use a case-based review of some of the more common soft tissue diagnoses to serve as a guide for navigating soft tissue lesions and tumors. The diagnosis of soft tissue lesions is a team effort, requiring clinical and radiologic integration to help assist in the pathologic evaluation. There are instances where a definitive diagnosis cannot be rendered, yet an informative report to guide management can still be rendered.
By working to separate soft tissue lesions into distinct categories, something that can often by achieved on the cytomorphology of aspirations or touch preparations, can facilitate their pertinent ancillary workup. The main categories include stromal predominant, spindle cell, adipocytic, small round cell, epithelioid, and pleomorphic tumors. Once such a classification is made, the differential diagnoses can be narrowed to a scope that allows for targeted immunohistochemical and in FISH testing workups.
This session will focus on the new developments in tick-borne diseases. Special attention will be given to the emerging pathogens Borrelia miyamotoi and Powassan virus. Tick-borne disease epidemiology will also be explored. Testing methods will be reviewed for many of the common tick-borne diseases, including lyme disease among other less frequently encountered infections.
The healthcare industry continues to face the challenges presented by the COVID-19 pandemic. These challenges include falling margins, flattened revenues, and rising expenses. Given the low Diagnosis Related Group (DRG) based reimbursement under the Centers for Medicare & Medicaid Services (CMS) prospective payment system, it is more important than ever for hospitals to focus on quality measures to provide timely and effective care, prevent complications and deaths, reduce readmissions, and minimize the overall cost of care. While Case Management is typically tasked with addressing these issues, partnership with the clinical laboratory can provide valuable and unique insight and strategies.
Until recently, Case Management and clinical laboratories were thought to be an unlikely partnership, however, this webinar will explore real world examples of how collaboration with the laboratory can improve quality metrics within a hospital and demonstrate the value of the clinical laboratory. Dr. Fletcher will outline laboratory strategies for driving improvement in length of stay, transitions of care, denials in payment, readmissions, and hospital-acquired conditions. Each of these strategies has potential to save millions of dollars or drive additional revenue while simultaneously improving patient care.
Clinical laboratories face immense challenges with the COVID-19 pandemic. While support for COVID-19 testing has been an essential focus of the coordinated clinical laboratory response, the pandemic influences laboratory operations in numerous ways that challenge the traditional concepts of laboratory management. In this webinar, ARUP Chief Operations Officer Jonathan Genzen, MD, PhD, details the challenges, setbacks, successes, and opportunities for development throughout the COVID-19 pandemic to consider as laboratories move forward.
The presentation provides an overview of practical past and current issues in testing for the SARS-CoV-2 virus. It includes discussion of the primary testing methodologies and ways in which the various platforms can be compared, with particular attention to issues of determining sensitivity of assays in low viral load specimens. Variant detection and sequencing are discussed, along with remaining testing needs for this and future viral pandemics.
Originally presented on February 1, 2021 for the annual Park City AP Update.
The severe acute respiratory syndrome coronavirus, SARS-CoV-2, and resulting pandemic have challenged laboratory medicine. As serologic tests are now ubiquitous and available on a variety of platforms, it is important to understand assay differences, regulatory issues, performance characteristics, utility, and limitations of SARS-CoV-2 antibody tests. The differences between these assays include methodology (lateral flow, high throughput assays), measuring different antibody isotypes (IgM, IgG, total antibodies) and use in different settings. The anticipated arrival of SARS-CoV-2 vaccines will further complicate the serology testing landscape. This session will provide a summary of antibody development in the context of SARS-CoV-2 infection, including concepts such as neutralizing antibodies, and also provide an overview of the status of the practical aspects of laboratory SARS-CoV-2 antibody testing.
Originally presented on February 1, 2021 for the annual Park City AP Update.
As healthcare costs continue to climb in the United States, drug costs are responsible for a disproportionate percentage of the overall healthcare spend. Pharmacogenetic testing has been scientifically validated as an option to help lower drug costs, yet little data exists on the testing's potential to improve patient care while also lowering health plans' costs. This presentation will provide the premise of pharmacogenetic testing then share how one self-insured company implemented pharmacogenetic screening of its high-risk populations as part of a collaborative laboratory/pharmacy stewardship program. Lessons learned and an examination of the financial and quality impacts of pharmacogentic panel testing will also be discussed.
Pathologic conditions characterized by peripheral cytopenia and bone marrow hypoplasia are not infrequent in community practice. The differential diagnosis usually includes many entities and the diagnostic work up may be very challenging. Increasing availability of molecular tests and emerging concepts of clonal hematopoiesis make the diagnostic investigation even more complex. The purpose of this presentation is to emphasize the importance of the diagnostic role of a pathologist, and delineate a practical step-by-step approach to bone marrow failure conditions including malignant, constitutional and idiopathic disorders.
A case based presentation will be used to discuss the differential diagnosis of basaloid head and neck tumors. Particular emphasis will be placed on salivary gland tumors and HPV-associated carcinomas.
This presentation will provide an overview of the factors that affect blood pressure and how the endocrine system plays an important role. Endocrine disorders that may present with high blood pressure will be reviewed. A focused discussion on primary hyperaldosteronism will explain how this disorder results in hypertension, and how laboratory testing is critical for its diagnosis. Finally, the problem of low blood pressure will be discussed, and laboratory testing for diabetes insipidus (which may present with low blood pressure) will be outlined.
Although the diagnosis and classification of lymphomas is highly dependent of morphology, some degree of ancillary testing is necessary in almost every case. Immunophenotyping is typically performed to assign or confirm lineage as well as to demonstrate the expected immunophenotype of the diagnosis. In some cases, an immunostain can serve as a surrogate marker for a recurrent genetic abnormality. Cytogenetic and genetic testing can also contribute to lymphoma diagnosis, and FISH testing in particular can identify specific entities and provide prognostic information. Genomic studies such as NGS do not yet play a significant role in lymphoma diagnosis, but a future increasing role is likely. This presentation will discuss the role of ancillary testing in lymphoma diagnosis and highlight a few entities where additional testing adds important information. The dependence of lymphoma diagnosis on morphology and particularly architecture leads to inherent challenges in making a specific diagnosis on needle core specimens. This presentation will also address some important caveats on this topic.
This presentation will provide valuable insight into how pharmacogenomics is being used in the leading clinical oncology centers today. Learners will gain a deeper understanding of germline and somatic pharmacogenomics through discussions of real-world applications in clinical scenarios.
The current COVID-19 (SARS-CoV-2) pandemic is a rapidly evolving global situation and laboratories play an important part in its management. This presentation will review current information about the virology of SARS-CoV-2, highlight the current approaches used for diagnosis and surveillance of the virus, and discuss the benefits and limitations of current laboratory testing methodologies.
| Number of Credits: CME: 0.75 | PACE: 0.5 |
This lecture will provide an in-depth coverage on the histologic variants of urothelial carcinoma. This lecture will review the diagnostic criteria, as well as common benign and malignant histologic mimics, in order to aid the practicing pathologist in developing a comprehensive differential diagnosis. This lecture will also highlight the importance of correctly classifying these histologic variants that have variable prognostic and therapeutic implications.
This presentation will provide a brief overview of blood pressure control by the renin-aldosterone system. Additionally, it will describe how primary hyperaldosteronism occurs when this pathway malfunctions, and how laboratory testing, especially adrenal venous sampling, is critical for diagnosis of primary hyperaldosteronism. Finally, interpretation of adrenal venous sampling results will be reviewed.
Because of the ongoing influences of reimbursement declines, budgetary pressures, staffing shortages, regulatory challenges, and more, hospital laboratories are at increased risk for becoming a "commodity" in the eyes of C-Suite members. Some hospital executives even question whether the laboratory is part of the hospital's core business, and have sold or are considering selling its hospital laboratory operation to an outside commercial entity. This presentation will examine these influences, debunk the myths, and provide attendees with strong supporting evidence for maintaining and expanding the role of the hospital laboratory in the local delivery of healthcare.
Prognostication, treatment and management of many solid malignancies are rapidly evolving due in part to revolutionary changes in the molecular diagnostics field. The increased shift to minimally invasive diagnostic sampling techniques coupled with efforts to enhance utilization of more limited diagnostic tissue samples ("do more with less") pose new challenges to the pathology laboratory team today. This educational session will 1) discuss some of the factors driving the trend toward increased use of limited small tissue samples, 2) highlight how rapid on-site evaluation (ROSE) is increasingly being used to optimize the adequacy assessment and triage of such small biopsy specimens, 3) compare the use of fine needle aspiration biopsy (FNAB) and touch preparation evaluation of needle core biopsy in ROSE and 4) illustrate how the synthesis and current application of this evolving body of medical knowledge, skills and attitudes have resulted in some lessons learned from selected clinical cases.
This presentation will focus on a variety of conditions in dermatopathology that may lead to an incorrect "overdiagnosis". It includes a discussion of squamous lesions that may mimic carcinoma and highlights clues to avoid the pitfall of misdiagnosis.
The advancement of technologies for high-throughput collection of personal data, including lifestyle, clinical and biomedical data, has inadvertently transformed biology and medicine. Integrating and co-analyzing these different data streams has become the research bottleneck and, in all likelihood, will be a central research topic for the next decade. My group has historically worked on the development of statistical and computational methods to identify key molecules (genes, microRNAs, etc) that affect disease onset and progression. More recently, we became interested in how we can combine the power of genomics with the rich medical data that are available. In this talk, I will present some of our recent efforts on causal modeling over mixed data types (continuous and discrete variables) and how to apply them to address important biomedical and clinical questions in chronic diseases and cancer diagnosis and therapy.
Laboratory stewardship, which has evolved from its predecessor of utilization management, is rapidly becoming an essential tool in the clinical laboratory's arsenal for improving quality patient care. This presentation looks at broad laboratory stewardship topics using the format first popularized by the game show Jeopardy!™. Using this format provides a fun, engaging, and entertaining experience for learners. Our "show" is hosted by Dr. Mike Astion, a widely known and published expert on laboratory stewardship, co-founder of PLUGS (Patient-centered Laboratory Utilization Guidance Services), and Medical Director of Seattle Children's Hospital Department of Laboratories. Timely and relevant commentary is provided by Dr. Jane Dickerson who is a co-founder of PLUGS and Director of Clinical Services at Seattle Children's Hospital and Dr. Andrew Fletcher who is the Medical Director of Consultative Services at ARUP Laboratories and also widely known and published expert in laboratory stewardship.
A radiology/pathology conference is a way for two disciplines to share their thinking process and learn from each other in how a differential is reached. In the this talk, we chose 3 recently received cases, that happen to be rare but described entities in the breast. Each has important differential diagnoses to exclude. We describe radiologic and histologic features, the differential, and relevant ancillary tests, such as immunohistochemistry and molecular tests, which help arrive at the ultimate diagnosis for each case.
Gastrointestinal lymphomas often present a diagnostic difficulty for the surgical pathologist for variety of reasons. In this presentation, we will discuss the aspects of such difficulties, review specific examples of lymphomas involving the GI tract, review relevant topics from the WHO2016 update to the Classification of Tumors of Haematopoietic and Lymphoid Tissues, and propose a rational and pragmatic approach to making a diagnosis.
This webinar will review the results from existing telemedicine adoption surveys, the impact to laboratory volumes and review the results of the recently executed ARUP Telemedicine survey. Additionally a case study will be presented to provide a comparison from another industry exploring the impact of diffusion of innovation on market share.
This two-part series provides an introduction to the science of cytogenetics. Cytogenetics is the study of chromosomes, genomic structure, function and variation, and the role of these aspects in human disease and heredity. Explanations will include the basics of technologies of chromosome analysis and karyotyping.
This two-part series provides an introduction to the science of cytogenetics. Cytogenetics is the study of chromosomes, genomic structure, function and variation, and the role of these aspects in human disease and heredity. Explanations will include the basics of technologies of chromosome analysis and karyotyping.
| Number of Credits: CME: 1.25 | PACE: 1.0 | Florida: 1.2 |
The dysplastic nevus has been the source of much controversy and debate since the term was coined in the 1970's. Many studies regarding this histologic entity have been performed over the years and the debate still exists about proper diagnosis and management of these nevi. The lecture will elucidate some of the recent advances in understanding these distinct entities and their relationship to melanoma risk.
| Number of Credits: CME: 0.75 | PACE: 0.5 |
Breast surgery has evolved significantly in the past several years with new treatments focusing on efficiency and accuracy in surgery, reducing morbidity and improving cosmetic outcomes for breast cancer patients.
New techniques for localizing nonpalpable breast cancer lesions have been developed that ease the work flow and scheduling of lumpectomy procedures.
Based upon large scale metanalysis there is a consensus on adequate margins for breast cancer lumpectomy margins. There are various methods that surgeons can employ to achieve negative surgical margins and reduce re excision rates.
Sentinel node biopsy has revolutionized axillary staging in early breast cancer and newer studies are showing that axillary dissection may have little benefit for most patients. Current studies are looking at utility of axillary dissection in patients who present with clinically positive axillary nodes and receive neoadjuvant chemotherapy.
Good cosmetic results in breast cancer surgery are important to patient well- being and satisfaction. New techniques to improve these results have been a welcome change in breast cancer surgery and oncoplastic and nipple sparing techniques are shown to be safe oncologic procedures as well.
Marketing in the reference laboratory industry has evolved over the past 50 years. In the early days, sales reps and upper management had to develop new and effective strategies and tactics that centered on selling a healthcare service as opposed to a product, such as equipment or pharmaceuticals. As such, lab sales reps have learned significant lessons over the years from those nascent times. The listener—either experienced or not—should find some nuggets of wisdom in this presentation that will help him/her grow their business as well as prevent the loss of an account to a competitor.
Clinical laboratories are increasingly called upon to share genetic testing data, as well as reevaluate results from previously performed tests for hereditary conditions. These efforts create unique opportunities and challenges during the diagnostic workup for new and previously tested patients. This presentation will provide an overview of current practices and policies surrounding genetic data sharing and variant reanalysis, with shared stories on successes and hurdles overcome to help patients with rare genetic disorders end their diagnostic odyssey.
In this lecture Dr. Tracy George focuses on the microscopy of cerebrospinal fluid, pleural fluid, peritoneal fluid, and pericardial fluid. Both normal and abnormal cell types will be shown and features that help distinguish benign from malignant cytology will be discussed. Recommendations for additional ancillary studies will also be explored.
This presentation will discuss the development and underlying rationale for developing the terminology of non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP). Criteria for recognizing NIFTP in surgical pathology will be discussed as will the implications for NIFTP for thyroid FNA. Updates to the second edition of The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) will be discussed including the impact of the NIFTP terminology.
This presentation will provide an overview of the Clinical Laboratory Improvement Amendments (CLIA) regulations described in Title 42, Part 493 of the Code of Federal Regulations along with basic CLIA standards and requirements for laboratory certification and/or accreditation.
Opioid medication abuse and misuse is a major cause of morbidity and mortality in the United States. The clinical laboratory plays a vital role as the healthcare system in the United States deals with the current opioid epidemic. This lecture is intended to help medical laboratory scientists gain a basic understanding of clinical uses of opioid medications, the short- and long-term effects of opioid use, and the different scenarios for performance of opioid testing for patients. In addition, this lecture covers laboratory testing methods for opioids and includes clinical cases to illustrate how test results can be combined with clinical information to determine individual drug use patterns in order to help build physician-patient relationships.
Non-small cell lung cancer is among the most common cancer types in males and females, in the US and worldwide, and currently has the highest mortality among all cancer types. Guidelines are continuously updated to reflect the most current state of knowledge on biomarker testing in this setting, and updated recommendations are in place as to what testing needs to be performed, based on pathological diagnosis and clinical presentation, along with what specimens can be tested and what characteristics the testing platforms utilized need to have. As the number of possibly actionable tests to be performed is increasing, it is important for the clinician and the pathologist to have an understanding of the clinical and technical aspect of this testing, in order to optimize the way specimens are procured and utilized for testing, especially in the setting of cytology and small biopsy specimens that are very common in lung cancer.
The molecular diagnostics of colorectal cancer has important clinical implications for the detection of Lynch syndrome and for treatment of colorectal cancer. Detection of mismatch repair deficiency, either by PCR or immunohistochemistry, is the current first step in the Lynch syndrome tissue work-up. Subsequent evaluation of BRAF mutation status and MLH1 methylation help assess whether a mismatch repair deficient tumor is sporadic or potentially Lynch-associated. Mismatch repair deficiency is also associated with a good prognosis and a response to immunotherapy. Finally, evaluation of the EGFR pathway, in particular mutations in KRAS and NRAS, is useful to determine the potential efficacy of therapy with EGFR inhibitors.
As controlled substances are prescribed in pain management and addiction treatment settings, urine drug testing is frequently adopted to monitor and assure clinical adherence to treatment plans. The purpose of such testing is to verify expected drug use, in addition to identify unexpected drug use. Because the clinical utility is different from traditional drug of abuse testing, the testing strategy and approaches are designed accordingly to minimize both "false positive" and "false negative" results. Based on the clinical utility of different drugs detected, the analytical workflow can be further adopted to optimize sensitivity and specificity of each individual drug.
This lecture will discuss uncommon variants of select genitourinary tumors of testis/paratesticular and renal/perirenal tissues with a focus on the differential diagnosis, key morphologic features, and when appropriate, ancillary testing.
| Number of Credits: CME: 1.25 | PACE: 1.0 | Florida: 1.3 |
The world has changed dramatically since the start of the COVID-19 pandemic, and this may be especially true of the clinical laboratory industry. Laboratories across the country have been caught in an extraordinary and contradictory set of circumstances—overwhelming pressure and demand for COVID-19 testing that has often been impossible to fulfill, coupled with crashing revenue and test volumes as patients across the country have been told to "shelter in place." Join us for this webinar as the ARUP Consultative Services team speaks with a panel of laboratory leaders throughout the country to explore what's changed in the industry, how laboratories can adapt, and what the future holds.
Spindle cell proliferations in the lung and pleura range from benign easily treatable diseases to malignancies with very short survivals. The samples are also very limited in many instances, making immunohistochemical triage a priority. The lecture will discuss the most common spindle cell processes encountered in lung and pleural samples and offer a reasonable way to work up individual cases without using up valuable tissue.
The optimization of pharmacy decisions is often based on trial-and-error, which may require several weeks to months for many drugs used in psychiatry due to less than desirable response, side effects, and potentially life-threatening toxicity. There are many medications available to treat depression, anxiety, schizophrenia, attention deficit and other behavioral health conditions. Research has shown that pharmacogenomics (PGx) and therapeutic drug monitoring (TDM) can help to inform drug and dose selections. This presentation will provide a background on PGx and TDM laboratory tests, along with some examples of how these tools are relevant to behavioral health.
Antimicrobial resistance has been recognized by the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) as a major global public health problem. Carbapenem resistance, a type of antimicrobial resistance, has been designated an urgent threat to public health here in the United States. Of particular concern are organisms that harbor transmissible genes encoding carbapenemase enzymes. Determining if an organism produces a carbapenemase and identifying which carbapenemase is produced can help guide antibiotic therapy in patients infected with these organisms, and can also be useful epidemiologically.
This talk will discuss carbapenem resistance mediated by carbapenemase production, and will provide information on several current test methods for the detection of carbapenemases in the clinical microbiology laboratory. Activity of newer antibiotics against individual classes of carbapenemases will also be discussed.
Learners will become familiar with current algorithms including immunohistochemistry and FISH testing in the work-up of diffuse large B-cell lymphoma, one of the most common lymphomas a pathologist is likely to encounter in routine practice. We will also discuss B-cell and T-cell clonality testing including how the assays work, when to use them and what the pitfalls are in ordering and interpreting these assays. Learners will leave with a better understanding of how these ancillary tests can be used in the work-up of lymphomas.
Celiac disease is a common and underdiagnosed small bowel disorder with a myriad of presenting signs and symptoms. There are also many clinically significant diseases that can resemble celiac disease histologically. Recent advances in the diagnosis of celiac disease and other small bowel malabsorptive disorders will be discussed, and the utility of key laboratory and clinical features will also be presented.
This lecture will focus on three areas of practical molecular pathology for the gastrointestinal (GI) tract:
- PD-L1 testing in the gastrointestinal tract, with practical information on ordering criteria, interpretation and specimen submission for testing. This will focus on the recent FDA approval of PD-L1 testing for immunotherapy in gastroesophageal adenocarcinomas, as well as other indications for testing and treatment in other GI malignancies.
- Molecular pathology of gastrointestinal stromal tumors (GISTs), with emphasis on the spectrum of genetic alterations seen in GISTs, and their management implications.
- Her2 testing in gastroesophageal adenocarcinomas, with emphasis on the current CAP-ASCP-ASCO guidelines.
During this presentation, we will discuss how order sets impact the laboratory and examine specific issues regarding test ordering. Next, we will explore an example of an efficient order set development/maintenance process and highlight how the laboratory can contribute. Physician preference items ("favorites") will also be discussed as well as possible solutions for optimization. We will offer specific examples of laboratory order set initiatives and optimization so that laboratorians can begin driving quality and cost reduction in their healthcare systems.
Extreme molecular diagnostics takes only seconds. With very short turn-around times, pre-analytical and post-analytical challenges are minimized, point-of-care testing makes sense, and high-throughput is not necessary. Extreme PCR in <15 seconds, high speed melting analysis in 4 seconds, and rapid sample preparation enable sample-to-answer diagnostics in <1 minute.
This presentation describes a pathway for health care technology companies to incorporate medical ethics into their business strategy. It provides counterexamples of health technology companies who failed to prioritize patient interests, and ultimately failed financially as a result. The medical ethical principles of respect for persons, beneficence and justice are briefly described, along with illustrations from the information technology sector.
Laboratory evaluation of acute leukemia although critical, is complex and is constantly evolving due to advancement in understanding the molecular basis of leukemia. Its implication is not only for diagnosis, but also for therapeutic and prognostic purposes. In recognition of the complexity of these testing algorithm, College of American Pathologists and American Society of Hematology have come up with guidelines to help clinician and pathologist in initial evaluation of acute leukemia. This presentation focuses on the classification, sample requirements and the tests needed on every patients as well as on a subset of patients. Prognostic and therapeutic implications of these newer molecular tests would be discussed briefly.
This lecture will help the practicing pathologist develop a best practice standard with regards to immunohistochemical stain usage in the urologic tract, specifically bladder, prostate and kidney. Immunohistochemistry should help guide and add to, but not dictate, a diagnosis. Thus, accurately integrating an immunopanel's results into the clinical history, gross examination and microscopy requires understanding when to order and how to appropriately interpret immunohistochemical stains. Differentiating between benign tissue, reactive processes and various urinary tract malignancies is the focus of this lecture.
Antimicrobial susceptibility testing (AST) results have a significant impact when managing patients with serious infections. Recent developments in identification tools can now identify microbes with unprecedented speed, but phenotypic susceptibility testing has lagged behind. New phenotypic AST systems are being introduced with the promise of improving current molecular tests by rapidly measuring inhibition of growth across panels of antibiotics. In this presentation, we will explore the technology, performance, and impact on patient care of these new, rapid AST methods.
Big data and artificial intelligence are revolutionizing most areas of society, and are poised to make a similar impact on health care and medicine. Like all new powerful technologies, AI has risks as well as benefits. If not carefully managed, AI can contribute to serious harm to patients in areas including privacy and nosocomial injury. This presentation will describe the nature of these risks along with potential approaches to reduce harm.
Viral infection of the central nervous system (CNS) results in a number of different clinical outcomes ranging from benign infection to life-threatening conditions as well as insidious disease characterized by viral persistence with potential for life-long neurological complications. Importantly, the past 20 years has recognized the emergence of neurotropic viruses that have caused a myriad of clinical problems and raised public awareness of the importance of studying viruses that infect the CNS. We employ infection of susceptible mice with the neurotropic JHM strain of mouse hepatitis virus (JHMV) to better understand the molecular and cellular mechanisms influencing host defense, demyelination, and remyelination. While the adaptive immune response is critical in effectively controlling viral replication as well as contributing to neurodegeneration, the contributions of the innate immune response to these processes is less well understood. We have recently determined that both neutrophils and microglia are important contributors in optimizing host defense following JHMV infection. In addition, we've shown that sustained infiltration of neutrophils into the CNS augments demyelination whereas microglia ablation limits the severity of white matter damage and restricts remyelination. We are currently attempting to address the mechanisms by which neutrophils and microglia influence these two separate events.
| Number of Credits: CME: 0.75 | PACE: 0.5 |
Large scale sequencing studies have expanded our understanding of renal cell carcinomas; identifying new information of the genomic landscape across different renal cell carcinoma subtypes. As research in this field unfolds, discoveries from these studies have had significant impact in not only identifying diagnostic molecular alteration, but also prognostic subcategories and therapeutically targetable genomic alterations. This talk will review the emerging genomic landscape of renal cell carcinomas, provide an overview of an integrative approach to molecular subtyping of this subset of tumors and the challenges and limitations of this approach, and address the role of a multi-omics approach in precision medicine for renal cancers.
This lecture will focus on the updates and new classifications relating to the WHO 2016 (4th edition) in Genitourinary tumors. The revised classifications have been implemented to better predict prognosis and treatment strategies for patients with various genitourinary tumors. The lecture will also introduce novel molecular profiling of tumors that relate to specific histologic tumor types.
Organizing pneumonia is not a new diagnosis but histologic variation can make recognition challenging. The hyalinized variant and its differential will be emphasized. In addition, granulomatous lung disease includes a few new entities, less familiar to general pathologists, but even rudimentary knowledge of them can help narrow the differential diagnosis in certain circumstances e.g. lung disease in common variable immunodeficiency, and primary biliary cholangitis. Finally, the lecture will focus on lung toxicity in patients on immune check point inhibitors.
The Doctor of Clinical Laboratory Science (DCLS) is an advanced practice healthcare practitioner dedicated to increasing the value of diagnostics through consultation as members of interprofessional healthcare teams and conducting research focused on evidence of the impact of diagnostics on healthcare outcomes. As a member of interprofessional healthcare teams, the DCLS contributes by providing consultation to assure quality & value improvement in utilization and delivery of laboratory services. Consultation occurs in a variety of setting as described in the Diagnostics Consultation Model©. Case examples will demonstrate the value of the DCLS consult to quality patient care, safety, laboratory utilization and cost outcomes.
There are hundreds of inflammatory skin diseases making inflammatory dermatopathology quite challenging. Appropriate diagnosis of cutaneous eruptions requires appropriate sampling of the eruption and careful clinical-pathologic correlation.
Since HER2 directed therapies became available for treatment of breast cancer, determining HER2 status of breast cancers has been an area of challenge and controversy. Changes in guidelines of HER2 testing and interpretation have contributed to the uncertainty in defining what is HER2 positive. This lecture will review briefly the history of HER2 testing and the most recent clinical evidence leading to the 2018 ASCO/CAP update of HER2 testing in breast cancer.
| Number of Credits: CME: 0.75 | PACE: 0.5 |
Lab and pharmacy interact on a daily basis, whether intentionally or incidentally. Identifying these areas is a starting point for a more collaborative partnership in patient care activities. There are also many benefits to each department and the hospital overall. In addition, emerging, high profile initiatives depend heavily upon teamwork and leadership from both lab and pharmacy for success.
It is crucial to correctly identify ABO discrepancies. All ABO discrepancies must be investigated and the underlying cause identified before a patient or donor's correct blood type can be resulted.
This panel discussion will cover some different outsourcing arrangements offered by commercial laboratories, focusing specifically on the impacts to laboratory personnel, clinician satisfaction, and patient care.
This video lecture is part three of a three-part series entitled "Don't Sell Your Lab Short."
Outsourcing laboratory services can produce short-term cost savings with long-term consequences. This presentation will describe economic and other factors that drive outsourcing arrangements, as well as economic and operational risks. Presenters will also discuss ways to articulate the value of the laboratory to administrators and executives.
This video lecture is part two of a three-part series entitled "Don't Sell Your Lab Short."
Does your lab currently obtain tests or other services from an outside vendor that could potentially be insourced? Or has your lab or hospital considered outsourcing some or all lab services to an outside company? These types of decisions are extremely common throughout healthcare, and they're often driven by top-down financial analyses, which, in some cases, leads to disastrous outcomes. This presentation will provide examples from healthcare and other industries to show how a more holistic approach to cost analysis can lead to better insourcing and outsourcing decisions.
This video lecture is part one of a three-part series entitled "Don't Sell Your Lab Short."
Names for lab tests have traditionally been chosen by clinical pathologists and scientists. While these test names make perfect sense to anyone in the clinical laboratories, that is not always the case with clinicians. Clinicians often order the wrong test or a sub-optimal test, or more tests than necessary, because the relevant test names are unclear or obscure. Often the wrong orders lead to safety and quality issues. Many hospital Utilization Management (UM) or Lab Stewardship efforts focus on correcting such test names, which is typically a slow and non-trivial process, as no standardized lab names exist.
This talk will discuss solutions to non-standard lab names, namely, TRUU-Lab, a collaborative effort among pathologists, clinicians, professional organizations, accreditation agencies, large reference labs and terminology groups to create a consensus guideline for giving laboratory test more rational and consistent names. The ultimate goal is to bring this consistency and ease of use into electronic health records (EHR) and laboratory information systems (LIS).
This session will discuss many of the interventions undertaken by the speaker at his institution to improve care delivery through laboratory stewardship interventions. Emphasis will be placed on laboratory leadership, collaboration with clinical colleagues, the importance of communication and professionalism, and a systems-based approach to problem solving. Evidence will be presented that these interventions, in addition to promoting healthcare affordability, directly improve the quality of healthcare delivered, as outlined by the Institute of Medicine.
This lecture provides an introduction to familial genetic testing, meant for non-genetics providers and other healthcare professionals. Standard genetics methodologies are reviewed, and considerations for streamlining test selection and ordering are discussed.
Having a strong ergonomics program can help decrease workers compensation claims and improve employee's performance. This workshop will focus on what ergonomics is and why it is an important element of a comprehensive occupational health and safety program.
We will review proper workstation setup, as well as laboratory ergonomic work practices and principals with a focus on repetitive tasks such as microscope use, pipetting, and miscellaneous hand tool and computer use. Additionally, we will identify what to include in an ergonomics program—from effective training to ergonomic assessments and everything in between.
Additionally, we will discuss specific laboratory case studies and work through problem-solving exercises to identify risk factors in a laboratory setting and how to mitigate the identified risk.
| Number of Credits: CME: 1.25 | PACE: 1.0 | Florida: 1.3 |
This session will provide an understanding of three fundamental concepts of quality control: stability, capability and controllability. The theory of each of these concepts will be described and will be followed with practical advice on how to apply these concepts in the real world. A top level approach to quality improvement will be presented along with practical tools to implement each phase of the quality improvement process. The goal is to provide participants with a practical approach to QC analysis and a roadmap for QC improvement.
| Number of Credits: CME: 0.75 | PACE: 0.5 |
In "Updates in Mastocytosis," Dr. Tracy George discusses the diagnosis, classification, and recent clinical trials work in mast cell disease. This orphan disease has been of intense interest recently with breakthrough therapies based on targeting of the D816V KIT mutation, approved by the FDA and EMA. Dr. George is an international expert in the pathology of mast cell diseases and a founding member of AIM (American Initiatives in Mast Cell Diseases). The inaugural meeting of AIM will occur at Stanford University in May 2019.
How should laboratories treat their clinician customers? On one hand, laboratories want to provide excellent customer service by accommodating their clinical customers' preferences. On the other hand, laboratories need to enforce standardized processes such as proper specimen submission. This pre-recorded webinar will provide examples from other industries to illustrate how a "tough love" approach can produce high levels of process quality and clinician loyalty at the same time.
Clinical laboratories often receive orders for tests that are outside the mainstream of clinical testing. Some of these are new/emerging tests for which there simply isn't a lot of clinical experience. Some are research biomarkers that are primarily of interest to bench scientists. Some are panels or algorithms designed largely in response to marketing considerations. What these all have in common is a lack of clinical evidence demonstrating clinical utility, i.e. therapeutic benefit for patients as a consequence of the tests. How should clinical labs evaluate requests for such tests? Historically many laboratories have approached these requests from a financial and/or logistical perspective, approving the tests as long as they don't overly burden the local laboratory (and provided that they are performed in a CLIA-licensed setting). This presentation will present an additional framework for consideration, namely bioethics. What is the ethical impact of such testing on the individual patient as well as on society as a whole? And how can potentially useful – but still unproven – laboratory tests be introduced into clinical settings in an ethically consistent manner?
Originally presented on July 10, 2018 as a live Seattle Children's Hospital Webinar Series
Cytogenetic testing is utilized across multiple areas of medicine for the diagnosis of heritable (constitutional) genetic conditions, as well as in cancer, particularly hematologic disease. This presentation will provide an overview on the utility of clinical cytogenetic testing for patients with developmental constitutional disorders, prenatal and perinatal diagnosis, pregnancy loss, and in cancer.
This presentation will delve into the concept of lab stewardship and its critical role for the future of laboratory medicine. Dr. Fletcher will also outline several strategies for implementing successful interventions to drive downstream savings in healthcare systems.
The ABO blood group system is the most important in transfusion medicine. This presentation covers basic ABO inheritance, antigen production and expression, and weak subgroups.
No short description
This lecture will describe the roles of a mentor and protégé. It will evaluate the responsibilities of each member of the partnership to ensure cross functional development within the organizations. It will describe strategies to use when setting up a successful mentoring program.
The aim of this presentation is to familiarize listeners with the relatively recently (9/2015) released IOM (Institute of Medicine) report on diagnostic errors and the importance of cognitive errors.
This lecture will examine how bullying in the workplace might be defined and specific examples of how these behaviors might be displayed. In addition, methods for addressing and dealing with bullying, as well as current legislative and organizational strategies, will be covered.
| Number of Credits: | PACE: 1.0 | Florida: 1.3 |
This course describes the Enzyme Linked Immunosorbant Assay (ELISA) testing method used in many analytical tests. Included are descriptions of the testing process and what is being tested. Animations are used to help illustrate what is happening at the molecular level.
Several effective approaches to antibody identification in the routine blood bank exist. This presentation explains a conservative approach to antibody identification and several demonstrations of ruling out, choosing appropriate selected cells, and completing antibody workups are given.
Laboratories are under intense pressure to increase value. Cost-effectiveness analysis (CEA) can help labs increase value by identifying optimum testing scenarios. This webinar explains important concepts such as cost-perspectives, methods for estimating costs, estimating outcomes, evaluating outcomes, and evaluating uncertainty in model outputs. At the end of this lecture, viewers will understand the different types of frameworks and analyses that are used in cost-effectiveness analysis.
The Lewis system is unique among blood group systems in that the antigens are not manufactured within the erythrocyte, nor do they form an integral part of the cytoskeletal membrane. Rather, they are synthesized by tissues, secreted into blood and body fluids, and adsorb onto the red blood cell. While antibodies against antigens in this system are fairly commonly encountered, they are generally not considered to be clinically significant in transfusion. In vitro and in vivo hemolysis are rare but have been reported. Because Lewis phenotype expression is based upon the interaction of several genes, and because the phenotype expression can be transient, the Lewis system is a fascinating system to learn about.
| Number of Credits: | PACE: 1.0 | Florida: 1.3 |
The understanding of anemias is very important as clinicians attempt to provide high quality medical care to their patients. The medical laboratory scientist must also understand anemias to provide the needed information to physicians. This lecture will address the basics of the classification of anemias and tools used in the medical laboratory to assess a patient's blood health or presence of anemia.
Hematology instrumentation has advanced to now routinely include at least a five-part differential and, in some laboratories, automated cell image analysis. Yet, a manual examination of the blood smear is still an essential procedure that provides valuable diagnostic information. This session will use case studies to define important morphologic variations and physiologic processes in selected disease conditions.
Laboratory formularies are an emerging tool for promoting effective use of the clinical laboratory. This presentation covers the key considerations for developing, applying, and managing a lab formulary: governance, process, evidence base, and analytics. In the end, a formulary is not so much a product as it is an interconnected system for managing and influencing diagnostic practices.
The impact of national healthcare reform, is putting pressure on the healthcare industry to navigate reductions in reimbursement, implement cost-cutting initiatives and improve patient outcomes and quality of life. Changing the way healthcare is delivered and paid for is the new imperative.
Laboratories, now more than ever before, have a unique opportunity to substantially impact both short and long term sustainability of healthcare organizations. However, labs that continue to just produce lab test results will be viewed as a commodity and will likely be outsourced or sold. Some organizations are selling laboratory and outreach operations to private equity firms, joint venture capitalists or national laboratories in exchange for an immediate and significant infusion of cash. It follows that laboratories failing to demonstrate value to the organization face an uncertain future.
This presentation will inform attendees of the industry trends that are influencing these decisions, the risks laboratories face and what labs can do to demonstrate value in tangible ways.
In this lecture, Dr. Schmidt covers performance evaluation of diagnostic tests. Traditional performance measures such as sensitivity, specificity and ROC curves are reviewed. Reasons for differences in diagnostic studies are examined including real differences, threshold effects, sources of bias, and random variation. Shortcomings of the traditional approaches to test evaluation are also discussed and alternative approaches such as diagnostic research (vs test research), clinical trial evaluation, and cost-effectiveness evaluation are presented.
Discrepant results are often identified by delta check alerts. Delta checks compare current laboratory results to previous results; if the difference between the two values exceeds predetermined biological limits (within a predetermined length of time), a technologist is alerted and the discrepancy can be investigated further. Causes of discrepant laboratory results include both preanalytical and analytical issues, as well as true biological changes occurring within the patient.
Many preanalytical issues cannot be detected by traditional QC methods, leading to the possible reporting of erroneous laboratory results. The wrong result compromises patient care by leading to inappropriate diagnoses or treatment. Delta check alerts provide an additional means to identify these types of problems, in addition to alerting health care providers to true changes in their patient's condition.
Clinical Laboratory Scientists are trained to perform laboratory tests and to troubleshoot and validate the results of those tests which contribute to a patient's medical diagnosis. During this presentation, we will compare the steps involved in pre-analytical, analytical, and post-analytical laboratory testing to the steps involved in pre-analytical, analytical, and post-analytical phases of developing leaders in the clinical laboratory.
Tired of fighting with the finance department to get the resources you need to carry out your mission? Ever feel that your CFO is from a different planet and that you just can't communicate? Do financial concerns kill creativity and stifle progress in your organization? Where is the peace? Where is the love?
This lecture will give you practical tips and tools to help your organization balance operational and financial considerations. First, this course unlocks the mysterious world of accounting . . . revealing the core principles, objectives, and concepts of this centuries-old art. Next, we tackle the sometimes thorny subject of "Margin" verses "Mission" providing some useful prospective on this important topic. Next, we shatter the language barrier, giving you simple terms and lingo to facilitate financial communications. Soon you'll be fluent in the latest accounting jargon. Finally, we conclude with some take-home financial analysis tools that will have your finance people saying: "Wow! – How'd you get so darn smart?!!!"
This shouldn't be shocking news to most healthcare professionals, but customer service IS a critical function of quality patient care. However, when we as laboratorians think about customer service activities and how that translates into patient care, we tend to think it's just about what occurs in the literal presence of patients. So, here's what may be news to some, the patient experience isn't just about what we do when we're in their physical presence, but also what we do as we interact with everyone who is in any way associated with their care. Therefore, we must make every effort to be engaged in skilled customer service activities with everyone, at all times. Now, the question may arise, what ARE the necessary skills and activities for providing great customer service (i.e., quality patient care) and how well do YOU execute them? This session will provide an opportunity for self-assessment utilizing a customer service skills preferred profile and an interactive discussion regarding the do's and don'ts for outstanding customer service.
Our traditional response to complex problems is to find and eliminate the human behaviors that we think are responsible for errors, and are perplexed when the error we thought we eradicated occurs again and again. We ignore the fact that 95% of process performance is attributable to the design of the work and the system in which the work resides and only 5% to the human component. The importance of creative design in the laboratory is often overlooked and its potential is underutilized. In this session we will discover how to design a work environment where error is, if not impossible, at least very difficult. Using innovative problem solving principles and techniques, we will open the door to organizational excellence by design.
This is a basic overview of the disease malaria and the causative agents, Plasmodium species. The life cycles of the parasites and their differentiating characteristics in the human host are discussed, for Plasmodium falciparum. P. ovale, P. vivax, P. malariae. Case studies demonstrate the disease states caused by each species.
Phlebotomists routinely encounter dangerous conditions, problem patients, and other issues during blood collection. This session will suggest techniques that can help you avoid or safely manage these difficulties. Areas to be discussed include:
- risks associated with venous blood collection, such as improper vein selection and needlestick exposure
- unusual patient situations that impact phlebotomy practice, including the cancer and bariatric patient
- communication barriers and methods to improve patient interactions, like developing good listening skills and effective communication approaches with the elderly
Designed for phlebotomists and phlebotomy students who have comprehension of the basics of the venipuncture technique, this session will enhance your skills, build your knowledge base, and help you deliver the highest quality in patient care.
Employees being able to report laboratory errors without fear is a key component of an effective error management system. This presentation will focus on the necessity for making the system useful and easy to use. Case studies are used to discuss a variety of errors and to illustrate how identification of errors can lead to practical solutions in error prevention. A just culture vs. punitive culture will be addressed along with ideas for getting employee "buy-in". Additionally, strategies for mentoring and coaching employees with high error rates will be provided.
Errors in specimen collection result in inaccurate results. This presentation focuses on identifying specimen collection issues and strategies for preventing them. We will discuss common errors in patient identification, phlebotomy techniques, and specimen labeling. We will also discuss identifying collection issues via pre-analytical processes, training for accuracy in collection, and monitoring improvement.
When we bring up the topic of change, we often think of it as a negative. But why? We're not opposed to changing a hairstyle, the color of our hair, changing cars, or even changing jobs. Now cell phone contracts are starting to lighten up so we can have a new cell phone almost every six months. There has been a lot of information written about the logical steps to change, but what about the human side of change? Cheryl Vincent will discuss the steps to change but also add a human dimension to the concept of Change Management.
Ms. Manning will give a comparison of the differences in learning in the laboratory and nursing professions. She will share personal examples of the struggles each profession has in understanding each other. She will also discuss practical ways to bridge the gaps in understanding between the two professions. Ms. Manning encourages the audience to be interactive and to share problems as well as best practices and successes in bridging the gap between these two professions.
Eradicating error in healthcare may seem like a Sisyphean task, yet legislators, regulators and the public in general expect error-free work from medical professionals. How to work without error is the subject of countless lectures, papers and studies, encompassing every discipline from manufacturing to service. The Toyota Production System of quality manufacturing uses the term "poke-yoke" (mistake-proofing) to describe the process of eliminating production defects. "Error-Proofing in Healthcare" will distill and discuss the essential elements of "poke-yoke", starting with defining and exploring the types of error most often encountered in the provision of medical care. Proven improvement tools and techniques for ensuring quality outputs will be presented with practical applications to place the error-proofing strategy in the context of the laboratory.
Rcc Design Video University Lectures Online Free
Source: https://arup.utah.edu/education/videoIndex.php
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