Video Lectures

The video lectures below are provided as an educational opportunity and resource for laboratory professionals. “Current video lectures” provide FREE continuing education credits upon the completion of a quiz which is provided after the video is viewed in its entirety. The quiz must be passed with a score of 80 percent or higher to obtain credit.

Credit Types Available: (click icon to filter)
C = CME |  S = SAM |  P = P.A.C.E. |  F = Florida | Show All |


Video Lecture Credit Types
Assessing Laboratory Performance for Next Generation Sequencing Based Detection of Germline Variants through Proficiency Testing by Karl V. Voelkerding, MD, FCAP
Number of Credits: 1.0

Participation in proficiency testing (PT) is a required external quality assurance activity for laboratories that are CLIA certified. The College of American Pathologists (CAP) provides a diversity of PT programs administered globally. This presentation will focus on the development and implementation of two PT programs by CAP for laboratories utilizing next generation sequencing (NGS) based diagnostic assays for the detection of germline variants. The first program uses DNA samples and is designed as a method-based PT to assess a laboratory’s total analytical NGS processes. The second program, new and designed for laboratories performing exome sequencing for undiagnosed disorders, uses an in silico sequence data file approach to assess laboratory bioinformatics and causative variant identification processes. The elements of these two programs, along with laboratory results from the method-based PT program, will be presented.

C S P F
Challenging Cases in Medical Liver Disease by John Hart, MD
Number of Credits: 1.0

Medical liver diseases can present numerous diagnostic dilemmas for the surgical pathologist, as there is a limited spectrum of histologic changes and considerable morphologic overlap among disease states. An approach to medical liver disease diagnosis will be presented that utilizes pattern recognition in combination with interpretation of key laboratory data and elements of the available clinical history to arrive at a final diagnosis, or at least a limited differential that is of value to clinicians.

C S P F
Multiple Sclerosis: Clinical Features & Laboratory Evaluation by Nicole E. Stanley, MD
Number of Credits: 0.5

Multiple sclerosis (MS) is a common neurologic disorder and one of the most common CNS causes of disability in young adults. It is a chronic, immune-mediated demyelinating disorder affecting neurons of the central nervous system. Symptoms are often nonspecific, and patients’ clinical courses can vary widely. This presentation provides an overview of the pathophysiology and risk factors for MS, the clinical, radiologic, and laboratory diagnostic processes, and the management of patients with MS.

C S P F
Screening for Inborn Errors of Metabolism Using Untargeted Metabolomic Profiling by V. Reid Sutton, MD
Number of Credits: 1.0

Metabolomics is used to measure small biochemical compounds in biological fluids and provides a comprehensive picture of perturbations in metabolic pathways. Untargeted metabolic profiling using mass spectrometry has the potential to enhance the detection of inborn errors of metabolism (IEM). This presentation describes the analysis of metabolic patterns in clinical specimens to assist in diagnosis of rare disorders.

C S P F
Introduction to the ABO Blood Group by Justin R. Rhees, MS, MLS(ASCP)CM, SBBCM
Number of Credits: 1.0

The ABO blood group system is the most important in transfusion medicine. This presentation covers basic ABO inheritance, antigen production and expression, and weak subgroups.

C S P F
Overview of the AACC 2018 Laboratory Medicine Practice Guideline – Using Clinical Laboratory Tests to Monitor Drug Therapy in Pain Management Patients by Gwendolyn A. McMillin, PhD
Number of Credits: 1.0

Clinical laboratories are now routinely engaged in the urine drug testing performed to assure adherence to therapy in chronic pain management patients, particularly when opioids are prescribed. This type of testing is unique from traditional workplace drug testing and emergency toxicology yet no practice guidelines have been available… until now! The AACC Academy has recently published the first laboratory medicine practice guidelines for monitoring adherence to therapy in chronic pain management patients. This presentation will describe the process for authoring the guidance document, as well as review the 26 evidence-based recommendations and 7 consensus-based expert opinions, emphasizing how laboratories can promote appropriate utilization and practices.

C S P F
Laboratory Stewardship: Taking the First Steps to Downstream Savings by Andrew Fletcher, MD, CPE
Number of Credits: 1.0

This presentation will delve into the concept of lab stewardship and its critical role for the future of laboratory medicine. Dr. Fletcher will also outline several strategies for implementing successful interventions to drive downstream savings in healthcare systems.

C S P F
Evidence-Based Immunohistochemical Panels for the Diagnosis of Hepatocellular Neoplasms by Sanjay Kakar, MD
Number of Credits: 1.0

Discussion of challenges in the diagnosis of focal nodular hyperplasia, hepatocellular adenoma and well-differentiated hepatocellular carcinoma. Interpretation of different clinical scenarios will be addressed with an emphasis on implications of the diagnosis on patient management. The subtyping of hepatocellular adenoma and the significance of beta-catenin activation will be discussed.

C S P F
Mystery Illnesses: Developing a Path to Caring and Discovery by Rong Mao, MD, FACMG, and Lorenzo D. Botto, MD
Number of Credits: 1.0

Rare and undiagnosed diseases are increasingly a recognized priority for health and research. Of the estimated 7000 known rare diseases, only a fraction have their molecular and mechanistic bases delineated. These conditions have a disproportionate impact on families and health care costs. They also represent a unique opportunity for discovery of the biologic bases of disease and potential drug targets. To address these challenges, the University of Utah has developed the Penelope Program, a combined clinical and research program that integrates team-based cognitive expertise with advanced genetic testing to optimize the path to care and discovery. We will describe the program’s approach and results to date, with a focus on the spectrum of rare or new conditions discovered so far, and the implications for clinical management and translational research.

C S P F
Introduction to Cytogenetics by Erica F. Andersen, PhD, FACMG
Number of Credits: 1.0

This lecture is an introduction to the science of cytogenetics. Cytogenetics is the study of chromosomes, genomic structure, function and variation, and the role of these aspects in human disease and heredity. Explanations will include the basics of technologies of chromosome analysis and karyotyping.

C S P F
Implementing Clinical Whole Exome Sequencing for the Care of Children with Mendelian Disorders and Cancer by Sharon E. Plon, MD, PhD, FACMG
Number of Credits: 1.0

Whole exome sequencing (WES) is utilized for the clinical care of children with Mendelian disorders and cancer. This presentation reviews experiences and current implementation of WES across clinical contexts including the newborn ICU and pediatric oncology.

C S P F
HIV Update in Laboratory Testing by Patricia R. Slev, PhD
Number of Credits: 1.0

New recommendations for laboratory diagnostic testing for HIV were officially published by the CDC in June 2014. Understanding appropriate test utilization and result interpretation for HIV diagnosis is critical for compliance and patient care. This presentation will address the new algorithm and review the evidence and rationale in support of the new guidelines.

Originally presented on January 30, 2015 and updated on September 6, 2017 in Salt Lake City, Utah

C S P F
Star Wars of the Body Besieged: A Review of Immunology and Immunodeficiency by Harry R. Hill, MD
Number of Credits: 1.0

Dr. Hill relates the major portions of the body's host defense system to the military's Star Wars that protects us from external and internal invaders. He describes the laboratory assays utilized to assess each portion of the immune and inflammatory system. Lastly, he shows individual patients he has seen over the past 40 years in his Clinical Immunology/Immunodeficiency Clinic at University of Utah which illustrate the various immune defects and the infections they suffer. He presents this in a manner so one can understand this complex system, know how to evaluate it and use in the clinical laboratory to help these seriously affected patients.

C S P F
Novel Approaches to ID Testing Using NGS-Based Metagenomics by Robert Schlaberg, MD, Dr Med, MPH
Number of Credits: 1.0

Metagenomics, the genomic analysis of a population of microbes, enables the profiling of microbial communities in the environment and the human body at unprecedented depth and breadth. Its application in the diagnosis of infectious disease is enabling the rapid and accurate detection of thousands of pathogens in patient samples without the need for clinicians to suspect the likely cause and order the right test. This lecture discusses approaches, promises, and challenges for the use of metagenomics-based testing in the diagnosis and management of infectious syndromes.

C S P F
Pancreatic EUS-FNA: Current Topics and Helpful Hints by Benjamin L. Witt, MD, and Douglas G. Adler, MD
Number of Credits: 1.5

The course will focus on emerging trends in EUS-FNA of the pancreas including the emergence of novel needle types and the potential impact of rapid on site evaluation. A case-based approach will be used to highlight some of the potential pitfalls in both solid and cystic lesions of the pancreas. The lecture will include both a cytopathologist and clinician perspective on performing, reporting, and management of pancreatic EUS-FNAs.

C S P F
Interesting Cases in Gynecologic Pathology by Michael Ward, MD
Number of Credits: CME/SAM: 0.75 PACE: 0.5

This is a one hour presentation of four interesting and challenging neoplastic GYN cases seen at the University of Utah and which have been seen in consultation by experts in GYN pathology at Massachusetts General Hospital, Boston, MA. Cases include unique presentations of common entities as well as more distinct tumors, and a discussion of the diagnostic features, differential diagnosis, and potential pitfalls for each.

C S P F
Kidney Stones: Diagnosis, Treatment, & Future Prevention by Jessica Corean, MD
Number of Credits: 1.0

Kidney stones are a common medical issue, affecting 1 in 11 people during their lifetime. Stones form when normally soluble material supersaturates in the urine and begins to crystalize. Management is dependent on stone size, but includes hydration, pain medication, and removal of stone. In pediatric patients or repeat stone-forming patients, stone analysis and supersaturation profiles are important for long term management and prevention. There are numerous stone compositions, which can indicate possible underlying pathologies or target therapy. Without appropriate treatment, reoccurring kidney stones can cause permanent renal damage or failure. This presentation provides an overview on kidney stone clinical presentation, laboratory and radiographic findings, composition types, and spontaneous and familial risk factors.

C S P F
Adventures in Arbovirus Diagnostics by Benjamin Pinsky, MD, PhD
Number of Credits: 1.0

Zika virus (ZIKV) is an Aedes mosquito-borne flavivirus that emerged in Brazil in 2015 and then rapidly spread throughout the tropical and subtropical Americas. Based on clinical criteria alone, ZIKV cannot be reliably distinguished from infections with other pathogens that cause an undifferentiated systemic febrile illness, including infections with other common arboviruses such as dengue virus. This presentation details the nucleic acid amplification tests and serological methods that are available to diagnose ZIKV infection.

C S P F
A Quick Guide to the Analytics Behind Genomic Testing by Elaine Gee, PhD
Number of Credits: 1.0

This course features introductory information about the role of bioinformatics in clinical genomic testing by NGS from the perspective of a national reference laboratory. An overview of the various types of bioinformatics pipelines, variant detection methods, and the computational infrastructure supporting these analytical pipelines will be discussed. This course will end with an overview of the validation strategy for bringing a new bioinformatics platform online for clinical production.

C S P F
WHO Updates for Myelodysplastic Syndrome and Myeloproliferative Neoplasms by Jay L. Patel, MD, and Archana Agarwal, MD
Number of Credits: 1.0

This presentation will cover WHO updates for both myelodysplastic syndromes and myeloproliferative neoplasms. For myelodysplastic syndromes, emphasis will be placed on the role of somatic gene mutation testing in the diagnosis and prognostication. The challenge of distinction of myelodyspslastic syndromes from preclinical states characterized by clonal hematopoiesis will be discussed. As for updates related to myeloproliferative neoplasms (MPNs), categories have not changed significantly except the exclusion of mastocytosis. Mastocytosis is now a separate category due to its unique clinical and pathologic features. The update will focus on the molecular as well as the clinical and pathological changes that have been incorporated into the current diagnostic categories of MPNs.

C S P F
Behavior-Based Safety Programs by Christina K. Kulakowski
Number of Credits: 1.0

No short description

C S P F
The Sustainable Laboratory: Perspectives on Laboratory Outreach by Suzanne Carasso, MBA, MT (ASCP) 
Number of Credits: 1.0

Historically, laboratories have operated as revenue centers within hospitals, with providers ordering tests and payers willing to reimburse. Today, labs are trending toward becoming cost centers, with ever-diminishing profit margins. Subsequently, some health system administrators are asking ‘Why keep the laboratory in-house when we can outsource and cut costs?’ Commoditizing laboratory medicine may sound viable at first glance, but on deeper review, is not a sustainable strategy. Competitive differentiation comes from demonstrating unique value the laboratory provides that goes well beyond the price of a test or a test result.

Laboratory outreach is emerging as an opportunity for labs to provide value to hospitals and health systems by providing testing services for all patient types, regardless of location. In addition to lowering unit costs, increasing outreach test volumes provide new revenue streams, positions the laboratory to utilize excess capacity and operate more efficiently.

This session will include an overview of trends impacting labs, differentiate between price and value, and provide detail on laboratory outreach as an integral part of the sustainable laboratory.

C S P F
Value-Based Pathology: The Northwell Experience by James M Crawford, MD, PhD
Number of Credits: 1.0

The rapid changes in American healthcare provide unprecedented opportunity for Pathology and Laboratory Medicine to create enhanced value for our services. Conversely, the threats to our diagnostic services (being commoditized and subjected to downward revenue pressure) are extreme. Both threats and opportunities will be examined, serving as a call for leadership by Pathologists and Laboratory Professionals alike. Examples from the Northwell Health Laboratories (formerly North Shore-LIJ Laboratories) will illustrate how Northwell is responding to these changing times.

C S P F
Placenta Pathology by Jessica Comstock, MD
Number of Credits: 1.0

Placental pathology can be challenging. This lecture will review both common and uncommon diagnoses, especially those with important clinical implications, using the 2014 Amsterdam Placental Workshop Group classifications.

C S P F
Next Generation Sequencing of Hematologic Neoplasms by Todd Kelley, MD
Number of Credits: 0.5

This presentation will provide an overview of next generation sequencing based testing in hematologic malignancies.

C S P F
Harmonization: Why You Should Care! by Greg Miller, PhD, DABCC
Number of Credits: 1.0

The landmark 1999 report from the Institute of Medicine "To Err Is Human: Building a Safer Health System" emphasized the importance of clinical practice guidelines to standardize decisions and treatments. A 2015 follow up report "Improving Diagnosis in Health Care" again emphasized the importance of guidelines and stressed that cooperation among the health care team including laboratory professionals was essential to reduce diagnostic errors. Neither report recognized that diagnostic errors are made when non-harmonized laboratory test results are interpreted using fixed decision values in clinical practice guidelines. Harmonization of laboratory test results is one of the most pressing issues in laboratory medicine. The laboratory profession has developed an infrastructure for achieving harmonized (or standardized) results; yet several technical challenges have prevented a large fraction of our measurement procedures from achieving harmonized results. Recent initiatives are addressing the challenges to achieve harmonization. It is not widely appreciated that regulations can be an impediment to harmonization. Why do IVD manufacturers need to spend millions of dollars for regulatory approval to conform to international recommendations for harmonization that will improve the quality of patient care? Current activities to address these issues will be presented.

C S P F
Sudden Cardiac Death Prevention with Molecular Diagnostic by Rong Mao, MD, FACMG
Number of Credits: 1.0

Sudden cardiac death (SCD), also known as sudden arrest, is a major health problem worldwide. It’s been estimated to affect over 300,000 patients annually in United States; in the range of 50-100 per 100,000 persons. A dynamic triggering factor usually interacts with an underlying heart disease, either genetically determined or acquired, and the final outcome is the development of lethal tachyarrhythmias. A comprehensive DNA test can identify at a young age the patients at risk for SCD. Prevention and early treatment prior to the disease being expressed greatly benefits patients and reduces the risk of sudden cardiac death.

C S P F
Paroxysmal Nocturnal Hemoglobinuria: Rare But Real by Nahla Heikal, MD, MS
Number of Credits: 1.0

Paroxysmal Nocturnal Hemoglobinuria (PNH) is a rare disorder with progressive morbidities and mortalities. It is a life threatening disease that causes thrombosis, end organ damage, and impaired quality of life and demands early diagnosis and intervention. The International Clinical Cytometry Society (ICCS) Guidelines and International PNH Interest Group (IPIG) recommend evaluation of high risk patients. Identifying and screening of high risk patients is essential for the diagnosis, management and monitoring of PNH.

C S P F
Molecular Testing and Cytopathology: Downsizing Precision Medicine but not Precision by Georgios Deftereos, MD, FCAP, FASCP
Number of Credits: 1.0

Cytology is said to be the art of doing more with less. As minimally invasive tissue procurement techniques evolve and as there is an ever-increasing number of clinically relevant analytes in molecular oncology, this has never been more the case than in this era of precision medicine. There is the need for the cytopathologist, and the anatomic pathologist in general, to be able to understand indications for molecular testing, advantages and limitations of different testing platforms and to develop strategies in order to be able to provide quantitatively and qualitatively adequate specimen, without compromising diagnostic ancillary testing.

C S P F
Update on HPV Testing by Robert Schlaberg, MD, Dr Med, MPH
Number of Credits: CME/SAM: 0.75 PACE: 0.5

This talk will provide an overview of the biology and epidemiology of high-risk HPV infections and summarize concepts and performance of available cervical cancer screening tests. An update on recent changes to screening guidelines will be provided.

C S P F
Autoantibody Testing in the Diagnosis of Autoimmune Neurological Disorders by Lisa K. Peterson, PhD
Number of Credits: 1.0

Autoimmune neurology is a rapidly evolving field, with additional autoantibodies continually being identified. This presentation will focus on the laboratory’s role in diagnosing and managing autoimmune neurologic disorders, including paraneoplastic neurological syndromes (PNS), autoimmune encephalitis, and autoimmune neuromuscular junction disorders. Also discussed will be methods for detecting autoantibodies in serum and CSF, with an emphasis on their strengths and weaknesses, as well as testing strategies for autoimmune neurologic diseases.

C S P F
Update on Anticoagulants Monitoring Practice by Kristi J. Smock, MD
Number of Credits: 0.5

The direct oral anticoagulants (DOACs) currently include one direct thrombin inhibitor (dabigatran) and three direct factor Xa inhibitors (rivaroxaban, apixaban, edoxaban) which have various approvals for treatment and prevention of thromboembolic events, As opposed to more traditional anticoagulants, DOACs do not require routine laboratory monitoring due to predictable pharmacodynamics, pharmacokinetics, and wide therapeutic windows. DOACs have variable effects on routine coagulation tests, such as PT/INR and aPTT, depending on the specific drug, drug concentration in the specimen, patient and specific indication and dose, and assay, including the specific reagent used. Understanding DOAC effects on locally available routine coagulation tests may allow qualitative use of routine tests in emergent clinical situations but these tests do not reliably determine drug concentration. Although quantitative tests for the new drugs exist, they are not widely available, usually do not have turnaround times that would allow use in urgent clinical situations, and none are FDA approved. Aside from the issues with monitoring DOACs, it is also important for physicians and laboratory professionals to know that DOACs can interfere with specialized coagulation testing, such as thrombophilia testing, and that this testing should generally be avoided when DOACs are present.

C S P F
Employee Mentoring: Fostering a Culture of Contribution by Jo D Fontenot, MS, MT(ASCP)
Number of Credits: PACE: 0.5

This lecture will describe the roles of a mentor and protégé. It will evaluate the responsibilities of each member of the partnership to ensure cross functional development within the organizations. It will describe strategies to use when setting up a successful mentoring program.

C S P F
Diagnostic Errors in (Anatomic) Pathology by Michael Cohen, MD
Number of Credits: 1.0

The aim of this presentation is to familiarize listeners with the relatively recently (9/2015) released IOM (Institute of Medicine) report on diagnostic errors and the importance of cognitive errors.

C S P F
Role of Clinical Exome Sequencing in Diagnostic Odyssey by Pinar Bayrak-Toydemir, MD, PhD
Number of Credits: 0.5

As next generation sequencing technologies improve in accuracy and cost effectiveness, they will become standard in research and clinical laboratories. This presentation discusses exome sequencing in clinical testing. It will summarize clinical sensitivity of exome sequencing based on age, clinical findings, number of family members sequenced, and type of mutations. Two interesting exome cases will be discussed in details from clinical findings to reporting. There will be also a discussion about incidental/ secondary findings, and American College of Medical Genetics Recommendations.

C S P F
The Paris System by Eva M. Wojcik, MD
Number of Credits: 1.5

The Paris System for Reporting Urinary Cytology (TPS) has been developed by international group of members of the American Society of Cytopathology and the International Academy of Cytology to emphasize the goal of detecting High Grade Urothelial Carcinoma (HGUC) while minimizing the emphasis on Low Grade Urothelial Neoplasms (LGUN). Consequently, definition of the characteristics of the intermediate category of atypia aims at decreasing that category into a clinically meaningful one. Criteria for each category have been based on the best available clinical outcomes evidence. The uniqueness of the Paris System for Reporting Urinary Cytology lies in the fact that the system is based on understanding of the pathogenesis of urothelial carcinoma and recognizing two separate pathogenetic pathways; one leading to the development of a low grade urothelial neoplasm and the other leading to the formation of a high grade urothelial carcinoma, which is clinically significant and should be detected by cytology. From its inception, the system became enthusiastically accepted by cytology practitioners who recognized the significance of this more simplistic, but clinically significant, approach to urine cytology. It appears that urine cytology is no longer one of the most frustrating and difficult areas of cytology.

C S P F
EIN – The Final "Word" in Pre-Malignant Endometrioid Neoplasia by Elke Jarboe, MD
Number of Credits: 1.0

Endometrial intraepithelial neoplasia (EIN) is a monoclonal premalignant endometrial glandular lesion that precedes the development of endometrioid-type endometrial adenocarcinoma. EIN arises through complex interactions involving the sequential accumulation of genetic damage in endometrial glands and the positive selective pressure of unopposed estrogen. EIN is associated with a 45-fold increased risk of developing endometrial adenocarcinoma. In 2015, the American College of Obstetricians and Gynecologists and the Society of Gynecologic Oncology sanctioned EIN as the preferred diagnostic schema (over the WHO 1994 hyperplasia classification system) for diagnosing premalignant endometrial lesions.

C S P F
Human Microbiome in Health and Disease by David R. Hillyard, MD
Number of Credits: 1.0

Microorganisms have long been known to play an essential role in digestion and gut physiology. The advent of next-generation sequencing (NGS) and advanced informatics has accelerated research in this area, revealing complex signaling networks between microbes and their hosts beginning before birth. The role of the microbiome in health and disease is the focus of research that spans many disciplines, from nutrition and immunology to cardiology and neuroscience.

This presentation will review basic concepts of microbiome science, with a focus on advancements that suggest important causal relationships between the human microbiome and disease.

C S P F
Topics in Intraoperative Gynecologic Oncology by Mark Dodson, MD
Number of Credits: 1.0

This is a lecture addressing gynecologic tumors and the importance of accurate intraoperative and postoperative pathologic results. We will discuss the nuances of specific pathologic findings that direct our approach to clinical management of the patient.

C S P F
New Approaches to the Diagnosis of Prosthetic Joint Infection by Robin Patel, MD(CM), FRCP(C), D(ABMM), FIDSA, FACP, F(AAM)
Number of Credits: 1.0

Prosthetic joint infection occurs as a result of the formation of biofilms on the surface of orthopedic implants. The number of prosthetic joint infections is rising; diagnosis of this condition can be challenging. Our group has an over two decade history of performing studies to try to improve the diagnosis of prosthetic joint infection. A decade ago, we described a strategy to sample bacteria growing in biofilms on surfaces of removed joint replacements, an approach that is now a standard means of prosthetic joint infection diagnosis. In addition, this tactic is enabling us to answer a number of fundamental questions about the microbiology and pathogenesis of prosthetic joint infection through multiplex nucleic acid amplification panel, broad-range polymerase chain reaction and deep sequencing studies. Last year, we described an improved method for culturing tissue specimens from around orthopedic implants. We have defined how to interpret results of blood tests (e.g., CRP, ESR) and synovial fluid tests (e.g., cell count, neutrophil differential) for prosthetic joint infection diagnosis. This presentation will provide an overview of the diagnosis of prosthetic joint infection.

C S P F
Heparin-Induced Thrombocytopenia: The Dark Side of a Common Anticoagulant by George M. Rodgers III, MD, PhD, and Kristi J. Smock, MD
Number of Credits: 1.0

Heparin-induced thrombocytopenia (HIT) is a syndrome of platelet activation, thrombocytopenia, and thrombosis that occurs in 1-5% of patients who receive heparin. HIT is a clinicopathologic diagnosis where laboratory testing plays an essential role. Accurate and timely diagnosis is essential to avoid potentially life- or limb- threatening thrombotic complications. It is also important to avoid HIT over-diagnosis, which is common, and leads to suboptimal patient management. This presentation will emphasize the role of the laboratory in HIT diagnosis. At the conclusion, participants will be able to describe the syndrome, available laboratory testing, and optimal diagnostic algorithms.

C S P F
Sizing Up Cancer in Cell-Free DNA by Hunter Underhill, MD, PhD
Number of Credits: 1.0

During cell death, DNA that is not contained within a membrane (i.e., cell-free DNA) enters the circulation. Detecting cell-free DNA originating from solid tumors (i.e., circulating tumor DNA, ctDNA), particularly solid tumors that have not metastasized, has proven challenging due to the relatively abundant background of normally occurring cell-free DNA derived from healthy cells. This presentation will discuss the recent discovery that circulating tumor DNA has a distinctly shorter fragment length than normal cell-free DNA derived from healthy cells. The leveraging of this biological phenomenon to improve the non-invasive detection and diagnosis of solid tumors (i.e., the "liquid biopsy"), monitoring tumor recurrence, and evaluating tumor response to therapy will also be considered.

C S P F
Next-Generation Sequencing for Solid Tumors Diagnostics: Current Practice and New Developments by Larissa V. Furtado, MD
Number of Credits: 1.0

The role of molecular and genomic analysis in the diagnostic work-up of solid tumors continues to expand, with dramatic implications for clinicians, pathologists, and patients. With the recent surge of next-generation sequencing (NGS) adoption into clinical diagnostics laboratories, pathologists are more than ever required to actively participate as consultants on test selection and integrated clinical interpretation. This lecture will provide an overview of current next-generation technologies and their capabilities and indications for use in solid tumor diagnosis and management. These concepts will be reinforced with examples of personalized genomic analysis and management of a variety of solid tumors. Future trends in personalized tumor management will also be covered, including possibilities for testing of emerging specimen types, such as fine-needle aspirates and blood and other bodily fluids, from which trace cancer signals can be detected.

C S P F
Emerging and Zoonotic Infections by Marc Roger Couturier, PhD, D(ABMM)
Number of Credits: 1.0

With globalization of food products, pan-global human travel, and changing vector ranges for insects that carry disease, the rise of emerging and/or zoonotic infections has never been more prominent. Many recently emerging pathogens are zoonotic viruses and their emergence in new parts of the world is alarming and a challenge to medicine. Viruses such as Zika virus, chikungunya virus, MERS coronavirus, and ebola will be discussed, and the emerging enteric pathogen, Cyclospora will also be reviewed. A focus on sociopolitical as well as epidemiological factors will be considered for this topic, as both have significant implications in the emergence and persistence of these various pathogens.

C S P F
How to Develop an Effective Utilization Management Program by Robert Schmidt, MD, PhD, MBA
Number of Credits: 1.0

This presentation will provide practical examples of successful interventions and discuss the following key features of effective utilization management programs: getting started, designing the program, selecting projects, measuring progress, and maintaining momentum.

C S P F
Helicobacter pylori: Update on Disease, Diagnosis and Discouraging Trends by Marc Roger Couturier, PhD, D(ABMM)
Number of Credits: 1.0

Helicobacter pylori is one of the most common bacterial infections worldwide, with infection rates upwards of 50% of the human population.  While most of these infections are asymptomatic, a significant number of patients will develop severe disease due to this bacterial pathogen, including serious life threatening gastric cancers. The testing strategy for Helicobacter pylori will be reviewed, with particular focus on the non-invasive mechanisms of testing that are central to the clinical pathology laboratory and consistent with guidelines issues by multiple professional organizations. Finally, challenges related to proper test utilization and treatment failures will be discussed.

C S P F
Is There a Bully in the Room? by Tiffany A. Bradshaw, MLS(ASCP)CM
Number of Credits: 0.5

This lecture will examine how bullying in the workplace might be defined and specific examples of how these behaviors might be displayed. In addition, methods for addressing and dealing with bullying, as well as current legislative and organizational strategies, will be covered.

C S P F
Genomic Microarray in Constitutional and Oncology Settings by Erica Andersen, PhD
Number of Credits: 1.0

Genomic microarray analysis has utility across multiple areas of medicine as a clinical test for both heritable (constitutional) and acquired (oncologic) genetic abnormalities. This presentation will provide an overview of both the technical and interpretive aspects of genomic microarray analysis in order to facilitate better understanding of the clinical utility of this test.

C S P F
Quantitative Amino Acids Analysis for the Diagnosis and Follow Up of Inborn Errors of Metabolism by Irene De Biase, MD, PhD, FACMG
Number of Credits: CME/SAM: 0.75 PACE: 0.5

Inborn errors of metabolism are single gene disorders resulting from defects in metabolic pathways. Individually these disorders are rare, but collectively inborn errors of metabolism account for a significant portion of childhood disability and deaths. Moreover, they are in the differential diagnosis for common clinical emergencies, like neonatal sepsis and seizures. Correctly identifying these conditions is paramount, since prompt specific treatment is, in most cases, life-saving. Excluding a metabolic disorder requires several specific biochemical genetics tests, including the quantitative analysis of physiological amino acids in body fluids. This presentation will review the different methods used to quantify amino acids and amino acid-related compounds, and their use in the diagnosis and follow-up of inborn errors of metabolism.

C S P F
Medical and Non-Medical Testosterone and Steroid Hormone Usage by Amanda Ho, MD
Number of Credits: 1.0

Testosterone is a hormone present in both men and women with a variety of effects throughout the body. It’s prescribed by medical professionals for several different conditions and testosterone levels are commonly measured in patients receiving testosterone therapy. There are many different laboratory tests available to measure testosterone; choosing the proper test can be confusing. In addition to the medical usages, testosterone and similar anabolic-androgenic steroids are also used and abused to increase athletic performance or improve appearance. This presentation provides an overview of how testosterone works, how to choose the right laboratory test to monitor testosterone levels, and the similarities and differences between testosterone and anabolic-androgenic steroids.

C S P F
ELISA Science by The ARUP Institute for Learning
Number of Credits: PACE: 1.0 Florida: 1.3

This course describes the Enzyme Linked Immunosorbant Assay (ELISA) testing method used in many analytical tests. Included are descriptions of the testing process and what is being tested. Animations are used to help illustrate what is happening at the molecular level.

C S P F
FNA Cytology of the Head and Neck: Diagnostic Approach to Common Cases by Benjamin L. Witt, MD
Number of Credits: 1.0

This lecture will be an overview of FNA cytology of the head and neck using a case-based approach to discuss some of the more common diagnostic dilemmas. The topics that will be emphasized include lymph nodes, cystic neck masses, reactive reparative changes, and salivary gland lesions.

C S P F
Update in Salivary Gland Pathology by Benjamin L. Witt, MD
Number of Credits: CME/SAM: 0.75 PACE: 0.5

The classification of salivary gland neoplasms can be difficult due to the morphologic overlap between tumor types and the variability in patterns that frequent many of the tumors. The goal of this lecture is to focus on a selection of the common tumors of the salivary gland and illustrate their expected morphologic variability. Recommendations for immunohistochemical panels to help navigate certain differential diagnoses will be addressed. A couple of the newer topics in salivary gland pathology will also be discussed. This will include discussion on the recently described entity Mammary Analogue Secretory Carcinoma and the concept of high grade transformation in salivary gland carcinomas.

C S P F
Personalized Drug Therapy Is Here! An Update on Genetic Tools and Clinical Decision Support Available to Guide Drug and Dose Selection Today by Gwen McMillin, PhD, DABCC(CC,TC)
Number of Credits: 1.0

A person's response to a drug is dependent on many factors, including genetic variation. Targeted genetic testing can predict adverse drug reactions and therapeutic failure, as well as the need for non-standard dosing of several clinically important drugs. Expert consensus regarding implementing specific drug-gene associations has led to clinical decision support that can guide drug and dose selection based on genetic test results. This webinar will offer examples of how genetic testing can be used to personalize pharmacotherapy decisions.

C S P F
Diagnostic Trends in Laboratory Evaluation of Antiphospholipid Syndrome by Anne E. Tebo, PhD
Number of Credits: 0.5

Antiphospholipid syndrome (APS) is an autoimmune disease characterized by vascular thrombosis and/or pregnancy-related morbidity accompanied by persistently positive antiphospholipid (aPL) antibodies. Current recommended laboratory tests include immunoassays for detecting IgG and IgM antibodies to cardiolipin (aCL), and beta-2 glycoprotein I (anti-β2GPI) as well as coagulation-based assays for lupus anticoagulant activities. It is increasingly recognized that a subset of patients with classical features of APS do test negative for the recommended criteria aPL tests. While APS experts acknowledge that such patients may have clinical features that are not of an autoimmune etiology, ‘seronegativity’ for criteria autoantibodies may also be due in part to the absence of harmonization and/or standardization of current aPL antibody assays. Alternatively, patients ‘seronegative’ for the recommended tests may have aPL antibodies that target other antigens involved in the pathogenesis of APS with possible relevance for risk assessment and treatment. This presentation will focus on current and emerging aPL antibodies and the evolving concepts for their use in the evaluation and management of APS.

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Introduction to Antibody Identification by Justin R. Rhees, MS, MLS(ASCP)CM, SBBCM
Number of Credits: 1.0

Several effective approaches to antibody identification in the routine blood bank exist. This presentation explains a conservative approach to antibody identification and several demonstrations of ruling out, choosing appropriate selected cells, and completing antibody workups are given.

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Shiga-toxigenic E. coli: A Fully Emerged, Still-Underappreciated Pathogen by Marc Roger Couturier, PhD, D(ABMM)
Number of Credits: 1.0

Shiga-toxigenic E. coli (STEC) is an enteric pathogen associated with several foodborne infections throughout the world every year. The major virulence determinant that defines STEC is the Shiga-like toxin, which is capable of transmission between various gram-negative organisms. STEC causes significant morbidity during acute outbreaks and can cause mortality associated with the development of hemolytic uremic syndrome. Until recently, testing for STEC in the clinical laboratory was inadequate, relying solely on selective, serogroup-biased culture methods. Recent advancements have been made that allow for toxin detection or molecular detection of toxin genes from stool specimens, removing the culture-bias problem. With these improvements in screening, the cases of STEC reported have increased significantly, revealing a pathogen that may have eluded the laboratory for decades. The 2011 STEC outbreak in Germany will be discussed in detail as an example of the emerging nature of this enigmatic pathogen.

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Laboratory Testing to Support Pain Management: Methods and Case Studies by Frederick Strathmann, PhD
Number of Credits: 1.0

The focus of this presentation is on understanding the laboratory's role drug testing in the context of therapeutic drug monitoring, pain management, and drug abuse. Testing methods and principles including immunoassays and various mass spectrometry techniques are highlighted and comparisons are made between urine and serum regarding detection times and drug metabolite targets. In the context of several case studies, drug metabolism is reviewed and the broader concept of screening vs. confirmation testing is discussed.

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Cost-Effectiveness Analysis of Laboratory Tests by Robert Schmidt, MD, PhD, MBA
Number of Credits: 1.0

Laboratories are under intense pressure to increase value. Cost-effectiveness analysis (CEA) can help labs increase value by identifying optimum testing scenarios. This webinar explains important concepts such as cost-perspectives, methods for estimating costs, estimating outcomes, evaluating outcomes, and evaluating uncertainty in model outputs. At the end of this lecture, viewers will understand the different types of frameworks and analyses that are used in cost-effectiveness analysis.

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The Lewis System by Justin R. Rhees, MS, MLS(ASCP)CM, SBBCM
Number of Credits: 0.5

The Lewis system is unique among blood group systems in that the antigens are not manufactured within the erythrocyte, nor do they form an integral part of the cytoskeletal membrane. Rather, they are synthesized by tissues, secreted into blood and body fluids, and adsorb onto the red blood cell. While antibodies against antigens in this system are fairly commonly encountered, they are generally not considered to be clinically significant in transfusion. In vitro and in vivo hemolysis are rare but have been reported. Because Lewis phenotype expression is based upon the interaction of several genes, and because the phenotype expression can be transient, the Lewis system is a fascinating system to learn about.

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Diagnostic Approach to Anemia by Archana Mishra Agarwal, MD
Number of Credits: PACE: 1.0 Florida: 1.3

The understanding of anemias is very important as clinicians attempt to provide high quality medical care to their patients. The medical laboratory scientist must also understand anemias to provide the needed information to physicians. This lecture will address the basics of the classification of anemias and tools used in the medical laboratory to assess a patient’s blood health or presence of anemia.

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Hematology M+Ms: Morphology and Mystery (Case Studies) by Karen A. Brown, MS, MLS(ASCP)CM
Number of Credits: 1.0

Hematology instrumentation has advanced to now routinely include at least a five-part differential and, in some laboratories, automated cell image analysis. Yet, a manual examination of the blood smear is still an essential procedure that provides valuable diagnostic information. This session will use case studies to define important morphologic variations and physiologic processes in selected disease conditions.

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The Illusion of Quality: A Discussion of Roadblocks to Laboratory Quality and Case Studies of How to Make Things Better by Frederick G. Strathmann, PhD, DABCC (CC, TC)
Number of Credits: 1.0

The purpose of this presentation is to emphasize the need for every laboratory to continuously review its quality processes. The recent changes surrounding Equivocal QC practices provide an opportunity for laboratories to ensure minimum requirements are met and a chance to move towards raising the bar internally for quality requirements. Practical and real-world examples of how to prepare, implement, and measure the impact of changing quality will be presented and discussed.

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Laboratory Formularies: Improving Care, Reducing Costs by Brian R. Jackson, MD, MS
Number of Credits: 0.5

Laboratory formularies are an emerging tool for promoting effective use of the clinical laboratory. This presentation covers the key considerations for developing, applying, and managing a lab formulary: governance, process, evidence base, and analytics. In the end, a formulary is not so much a product as it is an interconnected system for managing and influencing diagnostic practices.

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The Value of the Laboratory: Invest or Outsource? by Suzanne Carasso, MBA, MT (ASCP)
Number of Credits: 1.0

The impact of national healthcare reform, is putting pressure on the healthcare industry to navigate reductions in reimbursement, implement cost-cutting initiatives and improve patient outcomes and quality of life. Changing the way healthcare is delivered and paid for is the new imperative.

Laboratories, now more than ever before, have a unique opportunity to substantially impact both short and long term sustainability of healthcare organizations. However, labs that continue to just produce lab test results will be viewed as a commodity and will likely be outsourced or sold. Some organizations are selling laboratory and outreach operations to private equity firms, joint venture capitalists or national laboratories in exchange for an immediate and significant infusion of cash. It follows that laboratories failing to demonstrate value to the organization face an uncertain future.

This presentation will inform attendees of the industry trends that are influencing these decisions, the risks laboratories face and what labs can do to demonstrate value in tangible ways.

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Testing a Test: Beyond Sensitivity and Specificity by Robert Schmidt, MD, PhD, MBA
Number of Credits: 1.0

In this lecture, Dr. Schmidt covers performance evaluation of diagnostic tests. Traditional performance measures such as sensitivity, specificity and ROC curves are reviewed. Reasons for differences in diagnostic studies are examined including real differences, threshold effects, sources of bias, and random variation. Shortcomings of the traditional approaches to test evaluation are also discussed and alternative approaches such as diagnostic research (vs test research), clinical trial evaluation, and cost-effectiveness evaluation are presented.

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Diagnostic Error & Laboratory Testing by Mark L. Graber, MD, FACP
Number of Credits: 1.0

Diagnostic error is a major patient safety concern, causing substantial harm and unnecessary medial costs. In every large organization, cases related to diagnostic error make up the largest fraction of filed claims and suits. Although the error rate is not being measured in any setting, it is estimated that 1 in 10 diagnoses is wrong, significantly delayed, or missed altogether. The root causes of diagnostic error include many system-based factors (eg breakdowns in communication, coordinating care, having expertise available when needed, supervision of trainees, etc) as well as cognitive shortcomings. The cognitive errors mostly derive from failures to synthesize the available evidence and inappropriate trust of intuition. Errors related to diagnostic testing are common, and include mistakes by the patient’s doctor (not knowing the best test to order or how to interpret it) as well as problems performing and interpreting the test results by the clinical lab or the Radiology department staff. Many interventions to reduce diagnostic error have been proposed, although few have been rigorously evaluated in clinical practice.

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The Delta Check in Action: Causes and Consequences of Discrepant Laboratory Results by Joely A. Straseski, PhD, MS, MT(ASCP), DABCC
Number of Credits: 1.0

Discrepant results are often identified by delta check alerts. Delta checks compare current laboratory results to previous results; if the difference between the two values exceeds predetermined biological limits (within a predetermined length of time), a technologist is alerted and the discrepancy can be investigated further. Causes of discrepant laboratory results include both preanalytical and analytical issues, as well as true biological changes occurring within the patient.

Many preanalytical issues cannot be detected by traditional QC methods, leading to the possible reporting of erroneous laboratory results. The wrong result compromises patient care by leading to inappropriate diagnoses or treatment. Delta check alerts provide an additional means to identify these types of problems, in addition to alerting health care providers to true changes in their patient’s condition.

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Laboratory Results - Beyond Patient Testing by Cheryl Vincent, MBA
Number of Credits: 1.0

Clinical Laboratory Scientists are trained to perform laboratory tests and to troubleshoot and validate the results of those tests which contribute to a patient’s medical diagnosis. During this presentation, we will compare the steps involved in pre-analytical, analytical, and post-analytical laboratory testing to the steps involved in pre-analytical, analytical, and post-analytical phases of developing leaders in the clinical laboratory.

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Blood Bank vs Piggy Bank: Keys to Harmonizing Margin and Mission by Kent Gordon, CPA, MAcc
Number of Credits: 1.0

Tired of fighting with the finance department to get the resources you need to carry out your mission? Ever feel that your CFO is from a different planet and that you just can’t communicate? Do financial concerns kill creativity and stifle progress in your organization? Where is the peace? Where is the love?

This lecture will give you practical tips and tools to help your organization balance operational and financial considerations. First, this course unlocks the mysterious world of accounting . . . revealing the core principles, objectives, and concepts of this centuries-old art. Next, we tackle the sometimes thorny subject of “Margin” verses “Mission” providing some useful prospective on this important topic. Next, we shatter the language barrier, giving you simple terms and lingo to facilitate financial communications. Soon you’ll be fluent in the latest accounting jargon. Finally, we conclude with some take-home financial analysis tools that will have your finance people saying: “Wow! – How’d you get so darn smart?!!!”

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Are You a Customer Service “Have” or “Have Not”? by Cherie V. Petersen, BA
Number of Credits: 1.0

This shouldn’t be shocking news to most healthcare professionals, but customer service IS a critical function of quality patient care. However, when we as laboratorians think about customer service activities and how that translates into patient care, we tend to think it’s just about what occurs in the literal presence of patients. So, here’s what may be news to some, the patient experience isn’t just about what we do when we’re in their physical presence, but also what we do as we interact with everyone who is in any way associated with their care. Therefore, we must make every effort to be engaged in skilled customer service activities with everyone, at all times. Now, the question may arise, what ARE the necessary skills and activities for providing great customer service (i.e., quality patient care) and how well do YOU execute them? This session will provide an opportunity for self-assessment utilizing a customer service skills preferred profile and an interactive discussion regarding the do’s and don’ts for outstanding customer service.

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Designing for Improvement by Bonnie Messinger, CPHQ, CMQ/OE (ASQ), Six Sigma Black Belt
Number of Credits: PACE: 0.5

Our traditional response to complex problems is to find and eliminate the human behaviors that we think are responsible for errors, and are perplexed when the error we thought we eradicated occurs again and again. We ignore the fact that 95% of process performance is attributable to the design of the work and the system in which the work resides and only 5% to the human component. The importance of creative design in the laboratory is often overlooked and its potential is underutilized. In this session we will discover how to design a work environment where error is, if not impossible, at least very difficult. Using innovative problem solving principles and techniques, we will open the door to organizational excellence by design.

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Review of Malaria and Plasmodium Species by DeVon C. Hale, MD
Number of Credits: 1.0

This is a basic overview of the disease malaria and the causative agents, Plasmodium species. The life cycles of the parasites and their differentiating characteristics in the human host are discussed, for Plasmodium falciparum. P. ovale, P. vivax, P. malariae. Case studies demonstrate the disease states caused by each species.

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Phlebotomy Ps and Qs: Problems and Quandaries in Specimen Collection by Karen A. Brown, MS, MLS(ASCP)CM
Number of Credits: 1.0

Phlebotomists routinely encounter dangerous conditions, problem patients, and other issues during blood collection. This session will suggest techniques that can help you avoid or safely manage these difficulties. Areas to be discussed include:

  • risks associated with venous blood collection, such as improper vein selection and needlestick exposure
  • unusual patient situations that impact phlebotomy practice, including the cancer and bariatric patient
  • communication barriers and methods to improve patient interactions, like developing good listening skills and effective communication approaches with the elderly

Designed for phlebotomists and phlebotomy students who have comprehension of the basics of the venipuncture technique, this session will enhance your skills, build your knowledge base, and help you deliver the highest quality in patient care.

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Reporting Laboratory Errors Without Fear by Lucinda Manning, BA, MT(ASCP), RN
Number of Credits: 1.0

Employees being able to report laboratory errors without fear is a key component of an effective error management system. This presentation will focus on the necessity for making the system useful and easy to use. Case studies are used to discuss a variety of errors and to illustrate how identification of errors can lead to practical solutions in error prevention. A just culture vs. punitive culture will be addressed along with ideas for getting employee “buy-in”. Additionally, strategies for mentoring and coaching employees with high error rates will be provided.

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Diagnosing Specimen Collection Issues by Ken Curtis, BS PBT(ASCP)
Number of Credits: 1.0

Errors in specimen collection result in inaccurate results. This presentation focuses on identifying specimen collection issues and strategies for preventing them. We will discuss common errors in patient identification, phlebotomy techniques, and specimen labeling. We will also discuss identifying collection issues via pre-analytical processes, training for accuracy in collection, and monitoring improvement.

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Test Utilization: Are You Driving the Bus, Chased by the Bus, or Under It? by Debbi Tiffany MSED, MLS(ASCP)CM SCCM SLSCM
Number of Credits: PACE: 0.5

This presentation provides an examination of how one laboratory reviews their test ordering patterns with information readily at hand while leveraging expert assistance to improve test utilization.

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The Human Side of Change Management by Cheryl Vincent, MBA
Number of Credits: 1.0

When we bring up the topic of change, we often think of it as a negative. But why? We’re not opposed to changing a hairstyle, the color of our hair, changing cars, or even changing jobs. Now cell phone contracts are starting to lighten up so we can have a new cell phone almost every six months. There has been a lot of information written about the logical steps to change, but what about the human side of change? Cheryl Vincent will discuss the steps to change but also add a human dimension to the concept of Change Management.

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When Professionals Meet: Bridging the Gap Between the Laboratory and Nursing by Lucinda Manning, BA, MT(ASCP), RN
Number of Credits: 1.0

Ms. Manning will give a comparison of the differences in learning in the laboratory and nursing professions. She will share personal examples of the struggles each profession has in understanding each other. She will also discuss practical ways to bridge the gaps in understanding between the two professions. Ms. Manning encourages the audience to be interactive and to share problems as well as best practices and successes in bridging the gap between these two professions.

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Error Proofing the Laboratory by Bonnie Messinger, CPHQ, CMQ/OE (ASQ), Six Sigma Black Belt
Number of Credits: 1.0

Eradicating error in healthcare may seem like a Sisyphean task, yet legislators, regulators and the public in general expect error-free work from medical professionals. How to work without error is the subject of countless lectures, papers and studies, encompassing every discipline from manufacturing to service. The Toyota Production System of quality manufacturing uses the term "poke-yoke" (mistake-proofing) to describe the process of eliminating production defects. "Error-Proofing in Healthcare" will distill and discuss the essential elements of "poke-yoke", starting with defining and exploring the types of error most often encountered in the provision of medical care. Proven improvement tools and techniques for ensuring quality outputs will be presented with practical applications to place the error-proofing strategy in the context of the laboratory.

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***The archived video lectures listed below no longer provide
continuing education credit
since their CE certification has expired.***