Laboratory Operations
Pathology and clinical laboratory services and consultation are available to meet the needs of patients of all ages served by Crestwood Medical Center, whose clinical needs range from mild to severe. Prompt performance of analyses is provided in the fields of anatomic pathology, hematology, chemistry, microbiology, clinical microscopy, parasitology, immunohematology (blood banking), serology, and virology.
Crestwood Medical Center Laboratory provides a full array of laboratory analyses on a continuous basis, 24 hours per day, 7 days per week. Testing is provided by a staff of laboratorians who meet CLIA personnel requirements. High quality of all testing is ensured by quality assurance programs, enrollment and participation in proficiency testing programs, internal competency assessment, regular inservice education programs, and external conference and workshop participation.
Clinical Laboratory Accrediation
As of September 1, 1992, all laboratories in the United States (except for those in the military and VA hospitals which have their own requirements and those laboratories generating only research data) are regulated by the Clinical Laboratory Improvement Amendments of 1988 (CLIA '88). CLIA '88 replaced existing regulations by extending the definition of a regulated laboratory to include any facility that evaluates material derived from the human body for health assessment or disease diagnosis, treatment, and/or prevention. CLIA '88 requires all laboratories to have a certificate that identifies the complexity of testing performed. To receive a certificate, laboratories must supply the Health Care Financing Administration (HCFA) with certain information, to include information concerning laboratory personnel, test volumes and tests offered.
Scheduled or random inspections follow. At this time, regulations included in CLIA '88 must be met to remain certified. Those laboratories choosing to be accredited by a nonprofit organization such as the Joint Commission of the Accreditation of Healthcare Organizations (JCAHO) or College of American Pathologists (CAP) will receive a certificate of accreditation. To be accredited by JCAHO, CAP, or some other "deemed" organization, the laboratory must meet the specific requirements of that organization, which, in order to have a "deemed" status must be at least as stringent as CLIA '88 regulations.
Crestwood's laboratory operates under the clinical and technical direction of Walter G. Grundy, M.D., a pathologist, and functions under the management and supervision of Darlene Cooper, the laboratory manager. It has been accredited by JCAHO.
Our Transfusion Services (Blood Bank) is accredited by JCAHO and also subscribes to the inspection and accreditation program of the American Association of Blood Banks (AABB). This accreditation goes above and beyond the JCAHO criteria and ensures compliance with standards set by professional blood bank peers.
People who work beyond the view of the public eye sometimes can become an unnamed "they" . The purpose of this web page is to identify the behind-the-scenes professionals who work in the medical laboratory, and shed light on what they do there.
What does each lab do?
The microbiology lab analyzes various specimens from the human body, such as urine, stool, and blood, as well as vaginal and throat swabs. The goal is to isolate infecting agents, such as bacteria, fungus, molds, and parasites. The isolated agents are then exposed to a variety of antibiotics to determine which drug is most effective for treatment.
The virology lab tests blood to identify viral infecting agents such as HIV, rabies, and viral meningitis.
The blood bank lab identifies blood types and performs tests to determine the compatibility of blood for transfusion. Other tests include Rh typing, antibody identification, and paternity testing.
The pathology lab performs biopsies on tissue samples. This is often done while a patient is in surgery. This test, called a "frozen section", because of the manner in which this test is performed, reveals to your surgeon if the organ or tissue causing your illness is malignant. This lab usually includes a cytology and histology department, responsible for tests such as Pap smears.
The hematology lab tests blood specimens to determine the type and number of red and white blood cells and platelets. This lab also determines the ability of a patient's blood to clot.
The chemistry lab provides information-nation about the concentration of proteins, carbohydrates, and fats (and other substances found in other body fluids such as spinal fluid and urine.
The emergency or STAT lab staff performs necessary tests to help physicians during life-and-death situations to determine a patient's immediate status and required treatment. The turnaround time for results in this situation is usually quite fast.
The serology lab tests blood to determine exposure to infectious agents such as hepatitis, syphilis, arthritis, and lupus.
Who works in the Crestwood lab?
Our lab is staffed by a Medical Director, a Laboratory Manager, a Technical Supervisor, Medical Technologists, also called Clinical Laboratory Scientists, Medical Laboratory Technicians, also called Clinical Laboratory Technicians, and Phlebotomists.
MEDICAL DIRECTOR, OR PATHOLOGIST:
Background: A physician with extensive education in pathology (the study and diagnosis of diseases through the utilization of laboratory results).
Certification: State-licensed M.D., plus special certification as a director is recommended.
LABORATORY MANAGER:
Background: A Medical Technologist often with dual degrees in medical technology and business administration at a bachelor's or master's degree level.
Certification: Certification as a Medical Technologist plus special certification as a director is recommended.
TECHNICAL SUPERVISOR:
Background: A Medical Technologist with additional experience and education in his or her specialty, such as hematology, microbiology, etc. Usually has a great amount of specialized technical training.
Certification: Certification as a Medical Technologist
MEDICAL TECHNOLOGIST (MT) OR CLINICAL LABORATORY SCIENTIST (CLS):
Background: Master's or Bachelor's degree in a biologic science, including a year or more of study in an MT program (e.t., biology, chemistry, microbiology, medical technology).
Certification: National certification and some states require licensing exams specific for that state
MEDICAL LABORATORY TECHNICIANS (MLT) OR CLINICAL LABORATORY TECHNICIANS (CLT)
Background: A graduate of a two-year certificate or associate degree MLT or CLT program.
Certification: National certification and some states require licensing exams specific for that state.
PHLEBOTOMISTS:
Background: A high-school graduate (or equivalent) with additional phlebotomy training.
Certification: Optional certification with a national certification exam.
How much do the professionals in the lab interact with doctors?
Medical laboratory professionals constantly communicate with physicians, nurses, and their support staff. Test results can be provided in written or oral form. Results are reported in several ways (1) a faxed report is sent to your physician's office as soon as the test is complete, (2) a "hard copy" of the report is mailed to your physician, (3) a copy of the report is included in your medical record at the hospital. Also, "critical" results, pre-established by a committee of physicians, are called immediately to the ordering physician. A physician needing help in interpreting test results may contact the Laboratory Director or any of our specialists in pathology, who are available around the clock for consultation. The pathologists, whose job it is to remain current on the rapidly changing field of diagnostic laboratory testing, may also recommend additional diagnostic testing which may be helpful in diagnosing and/or treating unusual or difficult cases.
What kind of technologies do lab professionals need to understand?
Medical labs are becoming increasingly high-tech. No matter how computerized labs become, there will always be a need for trained professionals to interpret the results and work with physicians to deliver the best possible health care and information to patients. Lab professionals also must understand statistics and chemical reactions, and be able to work with mainframe computers, networked analyzers, and rapid-access test kits.
How is my blood tested?
Depending on the test ordered, blood may be tested just as it is, as drawn from your arm or it may require spinning the blood at a high speed to separate the blood cells from the liquid part of the blood. Many blood tests are performed by skilled clinical laboratory scientists who use automatic blood testing instruments to take a sample of the body fluid and test it for the amount or concentration of a particular substance. Other blood tests require very specialized, manual testing methods.
What happens to my blood after it's tested?
Your blood sample is stored in our laboratory for up to 7 days, in case your physician wants to confirm a questionable result or to order an additional test. Although some components of the blood are unstable and will require a fresh sample, many tests may be analyzed from the original sample. Saving the blood will save you a stick! At the end of 7 days, blood samples are disposed of following government safety regulations (OSHA guidelines).
Who is taking my blood? Is that the same person who tests it?
The person who actually draws the blood from your arm is called a phlebotomist (flih-BOT-uh-mest). He or she specializes in taking blood, and is an expert at doing it as safely and painlessly as possible. The person who conducts the tests on your blood is a clinical laboratory scientist. He or she has received extensive training and works to ensure your blood is tested accurately. A lab pathologist analyzes any unusual test results, and reports back to your doctor.
How soon can I expect to hear the results of my blood tests?
All test results are sent or given directly to your physician, who will follow up with you. Our lab prides itself on its short turnaround times. Most frequently ordered lab tests are completed within hours. However, some of the less frequently ordered tests require longer turn-around times. And of course cultures and other microbiology procedures will require several days or weeks. For more information, please talk to your healthcare provider.
What is the laboratory role in preventive medicine?
Many health problems begin slowly, without visible symptoms. Our bodies reveal these problems, however, by changes in blood, urine or body cells. Laboratory tests can often detect these changes in time to take preventive action. For example, if testing reveals that your blood cholesterol level is over 200mg/dL, you can change your eating habits and lifestyle to help prevent heart problems.
Do lab tests only reveal bad news?
No! Your lab tests can provide you with very good news, including positive feedback on your wellness activities. Continuing with the cholesterol scenario from above, if you eat less total and saturated fat, less cholesterol and more complex carbohydrates, while exercising regularly, quitting smoking and losing extra pounds, you can control your cholesterol level. Subsequent visits to the lab will reveal the positive impact such efforts have on lowering your total cholesterol.
Why does the lab need to take my blood more than once?
You may need to visit the lab repeatedly, at which times fresh blood samples will be drawn. This is because your doctor has ordered follow-up testing. Your initial tests results may help your doctor diagnose a specific condition. Follow-up testing may be needed to monitor the effect of treatment or to follow the course of the disease. Or your initial results may be perfectly normal, establishing your personal baseline against which future tests can be compared.