Case raises uncertainty on autopsy’s legal status

Should a hospital-provided autopsy be considered health care? It’s a question the Supreme Court of Texas will decide this spring, and its answer to that question will make a big difference—in the millions of dollars—to the claimants, Christus Health Gulf Coast v. Carswell. It could also have an impact on the medical liability coverage available to pathologists who perform autopsies in the Lone Star State.

My lede for the top item in this month’s “Put It on the Board” section in CAP TODAY.

Lab shoots for better phlebotomy service, satisfied patients

Try running a race and tying your shoes at the same time. That is the kind of challenge laboratories face when they endeavor to refine their processes while providing all the usual services clinicians and patients expect. When laboratory leaders at Brigham and Women’s Hospital in Boston surveyed the landscape of their phlebotomy operations, they spotted many opportunities for improvement through Lean Kaizen events as well as technology that reduces the risk of human error.

On the outpatient side, patients showing up for blood draws encountered long waits, felt confused about when a phlebotomist would see them, and were even in the dark on the main outpatient phlebotomy area’s operating hours.

On the inpatient side, blood draw times varied widely from phlebotomist to phlebotomist, it often took more than half an hour after phlebotomists started work for them to draw their first patient, and the rate of preanalytical errors such as wrongly labeled specimens was too high.

Across inpatient and outpatient operations, the Brigham team—led by Milenko Tanasijevic, MD, MBA, and Stacy Melanson, MD, PhD—measured the phlebotomy capacity required at different times of the day and week and found that suboptimal staffing contributed to delays in collection and, consequently, longer patient waits and turnaround times.

Theirs is a multiyear project that has achieved dramatic improvements, among them a 76 percent reduction in average patient wait times and a 41 percent cut in specimen labeling errors.

My lede. Read the whole shebang    in this month’s CAP TODAY.

Cutting cultures: the move to all molecular in virology

For laboratories performing virology testing, taking advantage of molecular testing’s superiority to traditional testing methods is a no-brainer. But leaders in the University of Michigan’s clinical microbiology laboratory have found that the push to go all molecular for virology testing must be tempered by attentiveness to clinician preferences and a collaborative approach that’s likelier to make the journey a success.

So says Duane Newton, PhD, clinical microbiology director at the University of Michigan Health System in Ann Arbor. Compared with a high of nearly 6,000 viral cultures performed in-house during the 2009–2010 fiscal year, the Michigan clinical microbiology laboratory performed fewer than 1,000 viral cultures during 2014–2015, and that figure appears to be dropping to “essentially zero” in this fiscal year.

My lede. Read the whole shebang in the March issue of CAP TODAY.