Year in Review

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Exploring provoking statements, career advice and scientific breakthroughs from the past year’s coverage

Career Development

More important than any benefit of networking and career doors … is the chance for contribution to a passion society membership offers. Any of these events come down to the people involved, and that involvement—a way to drive progress in any field of medicine or science—may be what people desire more than anything else. Zanto stated, “That’s the reason for joining an organization—you want to give back to the profession that you love and try to make a little bit of a difference.

—Silas Gossman, “Joining a Professional Organization

Make a specific plan. Just as a patient care plan is important to a patient’s outcome, a well thought-out career plan is important to career success. What this is not is a nebulous, hazy idea that includes a job at the end. Instead, you must consider career goals in terms of achievable education, training and experience geared toward specific rungs on a career ladder. Start with a short-term plan—6 to 12 months. You are quite likely to know what is achievable in that range. Then expand outward—5 years, 10 years. Where do you want to be? What title do you intend to hold? Do not allow these goals, milestones and personal expectations to dissipate like some lofty cloud; put them in writing, review often and amend as necessary.

—Valerie Neff Newitt, “Charting a Successful Career

 Write a keyword-friendly resume. As agencies and human resources receive so many resumes, they often rely on software that searches for keywords to find qualified candidates. Placing the right keywords can make your resume jump to the top of the pile. Look at the job description to identify terms and phrases that appear most frequently. Then, use spelled-out and abbreviated versions of each one. For example, if you’re applying to a medical laboratory technologist position, you want to use both “medical laboratory technologist” and “MT” in your resume.

ADVANCE Staff, “10 Tips to Make Your Resume Stand Out

An “us versus them” attitude is common in all workplaces. Lab techs don’t understand nurses or nurses don’t understand lab techs. I’ve heard techs whine many times over the years, “If only the nurses could come down here and watch what we do for a day.” Never once have I seen a tech volunteer to do what a nurse does.
—Scott Warner, MLT(ASCP), “We’re All In This Together

Histology

When bringing a new antibody into the lab, there are several things to consider. Will this antibody work well on FFPE tissue? What controls, normal and/or tumor tissues will be needed? How many positive and negative cases will be needed for the validation process? …  If the lab purchases the antibody in a concentrate form, the antibody will need to be tittered for optimal working dilutions for that lab and the tissues processed at each lab. Start by reviewing the manufacturer’s specification sheets. These should include the protein concentration, suggested titer ranges, pretreatments and any other information that may be helpful, including pictures of the results. The technologist also needs to know if the staining pattern is nuclear, cytoplasmic or both.

—Sheron Lear, HT(ASCP)HTL, QIHC, “Considerations in Immunohistochemistry

Immunology

Patrick Soon-Shiong, MD, founder of NantWorks and the Chan Soon-Shiong Institute of Molecular Medicine, approaches cancer therapy with just such a transformative idea. “We must study a patient’s cancer at the genomic, proteomic, immunologic and metabolic level,” Soon-Shiong said. “This critical first step will transform cancer care from one that is based on trial-and-error treatment strategies that target the anatomy of the tumor to a precision medicine-based approach that routinely analyzes a patient’s cancer at the molecular level.”

He added that targeting a molecular profile with novel and more effective immunotherapies will harness the power of a patient’s own immune system and will “allow cancer to become a manageable chronic disease and provide patients with the promise of a long-term, high-quality life.”

—Valerie Neff Newitt, “Immunotherapy as a Cancer Treatment

Information Systems

Over the past few years, interoperability has become a red-hot topic in healthcare. The reason is simple: we must prepare for the move from a fee-for-service model to value-based care. This transition underscores the need to utilize available technologies to better manage clinical and financial risk sharing of a covered population. Yet for all the excitement around electronic medical records (EMRs) as a precursor to interoperability, they have not been the panacea that many hoped for them to be—their true value has yet to be realized. There’s a gulf between the opportunity and the day-to-day reality. A new generation of cloud-based vendors and service providers have been working hard to close that gap. The true value of interoperability will be realized when we have improved patient care and optimized costs, rather than meeting a set of federally mandated standards. In the end, it’s not only about lab data, but also sharing clinical data across the entire continuum of care.

—David Caldwell, “The Key to Interoperability

If we are to be credible experts, we must be certified and maintain current competency through continuing education. It is irresponsible to support the contention that passing one examination 15 or 20 years ago affords anyone current competence.
—Glen McDaniel, “Do We Practice What We Preach?

Management

One of the primary traits of a successful leader is the ability to inspire people around a purpose, a mission and a vision. Leaders who are most effective at motivating and organizing people towards a common vision do five key things very well. They work diligently at sharing their vision and persistently articulate the direction and mission of the organization. They outline the strategy and plan and openly communicate the company core values, their expectations and the definition of done. These five keys are the cornerstones to creating organization-wide alignment that boosts engagement, morale and overall success.

—Magi Graziano, “5 Paths to Employee Alignment

Microbiology

Illustrating the need to explore new infection control technologies, Zika, Ebola, Tuberculosis,

EV-D68 and other epidemics have demonstrated the negative impact diseases are capable of eliciting in the general population. This makes the need to explore new infection control technologies that are capable of strengthening the healthcare system’s defense against emerging pandemic threats urgent and necessary. However, while technologies have come about that are effective at killing a wide variety of pathogens, both bacterial and viral, research and developments must continue.

—Lindsey Nolen, “Infection Control Triggers

Molecular Diagnostics

“One important concept for understanding prostate cancer is that the vast majority of men diagnosed with prostate cancer will die of other causes,” Rubin told ADVANCE, “because it is common, very slow growing, readily followed, then treated later, if necessary. Early detection of prostate cancer has been controversial because we are often detecting a disease that doesn’t have the potential to kill.”

It is the interpretation of MDx for prostate cancer that may present a problem, not the tests themselves, which appear to perform well in detecting early disease. Rubin pointed to a number of assays, from such companies as Genomic Health, Oncotype DX, Myriad and others, that employ biomarkers for early prostate cancer. But important questions remain, even after the cancers are detected. “We still have to ask, ‘Do these patients need additional treatment? Should they just be followed? How aggressive is their prostate cancer?’” he detailed.

—Valerie Neff Newitt, “MDx for Prostate Cancer

 Defining a brand is important, but a brand is nothing without people to market it. Marketing helps to communicate the promise you want customers to know about. We market ourselves when we report out quality results and make turnaround times, but the things we do on the bench aren’t enough to market our brand. We need to market ourselves outside of the lab through an open dialogue about who we are and what we do, and this must be done throughout the 51 other weeks of the year in addition to Medical Laboratory Professionals Week.
—Stephanie Noblit, MLS (ASCP)CM, “A Promise Delivered

Pathology

“Most of the time, bone marrow biopsies are used to stage the patient because, if the bone marrow’s involved, the patient gets Stage 4 disease – especially important with low-grade lymphomas because, in low-grade lymphomas, about 70% of patients have bone marrow involvement, even relatively early disease stages like Stage 1 or 2,” said Istvan Redei, MD, chief, division of stem cell transplantation, department of medical oncology, Midwestern Regional Medical Center. “And [it is]important to see whether the patient has bone marrow involvement or not because that would have a major impact on treatment.”

—Michael Jones, “Non-Hodgkin’s Lymphoma

POCT

One of the many difficult aspects of glycemic management in the hospital is the timing of point of-care (POC) blood glucose (BG) testing, insulin administration and meals. The workflow surrounding this aspect of care is essential to optimizing blood glucose control and overall patient care. Either nurses or nursing assistants, depending upon the facility, perform POC testing, and this can further complicate the process. When each of the three responsibilities: meal delivery, POC testing and insulin administration are done by different individuals, the coordination of the three can be difficult and opportunities for failure abound.

—Andrew S. Rhinehart, MD, FACP, FACE, CDE, BC-ADM, CDTC; and Melanie E. Mabrey, DNP, ACNP-BC, BC-ADM, CDTC, FAANP, “Blood Glucose at the Point of Care

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