SPECIAL FEATURE :: HEMATOLOGY A timed study performed in the lab revealed that it
takes about five minutes for the RUMC techs to per- form each smear review. Raising the flagging thresh- old for IG eliminated approximately 25 smear reviews each day, saving almost 15 hours of tech time each week. The decrease in workload allowed the Core Lab techs more time to focus on problem patients, training activities and special projects. Implementing the changes to the slide review pol- icy was simple. Upon reviewing the study data, the hematopathologist was quick to approve the new flag- ging limit, noting that it may even be reasonable to raise the IG threshold to 10 percent in the future. The laboratory staff had been reporting automated IGs for more than 10 years, and IG was a trusted parameter among the techs and caregivers alike. Additionally, for the past number of years, the hematology techs were directed to validate the auto-differential (in lieu of performing a manual differential) whenever pos- sible. This practice contributed to widespread accep- tance of the IG result among caregivers and made it unnecessary to communicate the SOP changes to the medical staff.
In a lab that is operating 24 hours a day, seven days a week, and serving a 700-bed hospital with an ever-expanding outpatient population, the change in smear review procedures decreased TATs enabling technologists to spend more of their time assisting with other important bench work in the Core Lab.
The IG parameter is a critical part in allowing RUMC Core Lab to manage a swelling workload and at the same time, deliver quality laboratory results to healthcare providers.
REFERENCES
1. Singer M, Deutschman C, Seymour C, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016; 315(8):801-810.
2. Buoro S, Mecca T, Vavassori M, et al. Immature granulocyte count on the new Sysmex XN-9000: performance and diagnosis of sepsis in the intensive care unit. Signa Vitae. 2015; 10(2):54-64.
3. Nierhaus A, Klatte S, Linssen J, et al. Revisiting the white blood cell count: immature granulocytes count as a diagnostic marker to discrimi- nate between SIRS and sepsis – a prospective, observational study. BMC Immunology. 2013; 14:8.
4. Ansari-Lari MA, Kickler TS, Borowitz MJ. Immature Granulocyte Mea- surement Using the Sysmex XE-2100. Am J Clin Pathol. 2003; 120(5):795-799.
5. MacQueen BC, Christensen RD, Yoder BA, et al. Comparing automated vs manual leukocyte differential counts for quantifying the ‘left shift’ in the blood of neonates. Journal of Perinatology. 2016; 36(10):843-848.
Mary Anne Loafman, MS, MT(ASCP)SH, serves as Supervisor of Hematology in the Core Lab at Rush University Medical Center, Chicago, IL. As supervisor in a high-volume laboratory, Mary Anne strives to employ proven technology to increase efficiency while maintaining accuracy.
* * 6 * for on
* 6%CV at the 99th percentile for Troponin I. Source: IFCC Table of analytical characteristics of commercial cardiac Troponin I and T assay declared by the manufacturer – June 2017 (
www.ifcc.org)
Emergency Department, Food and Drug Administration, American Heart Association, Coefficient of Variation 800-431-2123
info@polymedco.com . 2018 Polymedco, Inc. LSI
cardiac events *
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