Keat H. Teoh, Arkansas State University, State University, Arkansas
Elaina M. Analitis, Rush University, College of Health Sciences, Chicago, Illinois
Jazmen Myers, Texas State University, San Marcos, Texas
Imagine a world without standards, where red did not always mean stop and green did not always mean go, where computer paper might or might not fit the printer, where plugs would not always fit the sockets, and where the lab test results in one hospital could not be used in another. In the world of health care the lack of standards has significant consequences. There may be delays in making a correct diagnosis, resulting in additional and unnecessary diagnostic testing and failure to provide the proper treatment. These consequences result in increased costs in time, personnel effort, and often in poor patient outcomes. Quality health care demands quality standards. Standards create a common language built upon consensus to enable the sharing of important information. Unless the health professionals are in agreement, the quality of care suffers. Organizations like CLSI play a very important role in fostering excellence in laboratory medicine through their development and implementation of clinical laboratory testing standards. CLSI, with its global connections and over 40 years of experience, is in a unique position to gather input from experts from around the world in industry, government, and health care in developing clinical laboratory standards of the highest quality.
I am in my junior year in the Clinical Laboratory Science (CLS) program at Arkansas State University, Jonesboro, Arkansas. I joined the Clinical Laboratory Science program after having spent many years as a research scientist in research laboratories in the United States and Canada. My areas of research have been mainly in medicinal plants. I have identified genes involved in the biosynthesis of anticancer as well as antimalarial drugs found in medicinal plants. I hold the patent for one of the genes for the biosynthesis of artemisinin, the latest and most effective antimalarial drug found in the Chinese herb Artemisia annua. I am enrolled in the CLS program to expand my knowledge and skills in the health profession with the hope of potential employment in laboratory science. I am excited to be in the health profession and to be part of the clinical laboratory science community. My experience in research laboratories has shown me first-handedly the importance of having good standards and guidelines for the laboratory, in the areas of laboratory management to laboratory safety to experimental protocols. Very often I encountered situations where results from hours and hours of hard work were invalidated because of a mistake in following the standard protocol or situations in which unproductive time was spent looking for misplaced chemicals and reagents that were not entered correctly into the inventory list. There were also situations where safety standards were not strictly adhered to, thus placing everyone working in the laboratory at risk.
The Clinical Laboratory Science department at Arkansas State University does a good job of instilling in the students the importance of following CLSI standards and guidelines in all aspects of clinical laboratory science. The CLSI standards and guidelines are incorporated into the curriculum where necessary. The students not only learn them in the classroom but also practice them in the laboratory sessions. The CLS department has emphasized that students working in the clinical laboratory must be familiar with the clinical laboratory safety standards as outlined in CLSI document GP17-A3. This past semester in phlebotomy, CLSI documents GP41-A6 and GP39-A6 were used to instruct students on the best practice of drawing blood, which included the order of the draw, patient identification, checking the requisition form for necessary information before a blood draw, and taking the necessary steps to prepare patients for the draw by making sure that the patient is comfortable and in the correct position. In hematology, CLSI document H02-A5 was followed when instructing the students on the procedure for the erythrocyte sedimentation rate test. H07-A3 was followed when instructing students on the procedure for determining packed cell volume by the microhematocrit method, and H47-A2 was followed when instructing students on the one-stage prothrombin time (PT) and activated partial thromboplastin time (APTT) tests. These are just some of the examples of how CLSI documents are used in the CLS department of Arkansas State University. Other CLSI documents used include those related to blood banking, clinical chemistry, microbiology, and immunology.
There is a lot going on in the clinical laboratory. The operations in the clinical laboratory are a complex of procedures and processes. Many tasks are performed and each of these tasks must be carried out correctly and orderly to assure accuracy and reliability of testing. Managing the operations in the laboratory would be a monumental endeavor if not for documents developed by CLSI that organized the laboratory operations into an understandable and workable structure. The quality management system model developed by CLSI addresses factors needed to be put in place to assure quality in the laboratory. As a future Clinical Laboratory Scientist, it would benefit me to be familiar with the CLSI standards and guidelines relating to my work in the clinical laboratory. Applying CLSI standards in my work will help me to perform my task in a timely, efficient manner and with accuracy, thereby increasing the quality of the test results. I have a strong background in molecular biology, and my hope for the future is to adapt my skills in molecular biology to clinical laboratory science and thus contribute to the improvement of molecular diagnostics in CLS. Having a good knowledge of CLSI standards and guidelines will no doubt serve me well for the task. My career goal is to be in a position to manage a clinical laboratory as a laboratory manager or director. Therefore, it will be very beneficial to me to be familiar with CLSI standards and guidelines relating to all aspects of work and organization in a clinical laboratory.
A clinical laboratory is a complex system, in which all aspects must function properly to achieve
quality results. The laboratory results play a major role in making clinical medical decisions, including diagnosis, confirmation, progress, and treatment. Therefore, accuracy of tests and promptness in delivery of the report are crucial in quality patient care. Errors in laboratory diagnostics are a major concern in health care. These errors can cause serious harm to patients and also translate into huge costs for the hospitals and the national economy. These errors can be greatly reduced by adhering to standards and guidelines such as those developed by CLSI.