2006 Annual Report
Mission Statement
The Program provides a community of cooperation and education to enhance the sharing of resources to improve quality and maximize the efforts of Regional Laboratory Services in providing a high level of services to our member hospitals and communities.
Values
Integrity
We act honestly, ethically and impartially at all times.
Professionalism
We encourage self-improvement and aim for scientific excellence.
Quality Assurance
We ensure that all our work is carried out in accordance with recognized standards.
Teamwork
We recognize the participation, initiative and cooperation of all the laboratories as being essential to our success.
Client Focus
We strive to recognize and anticipate the needs of clients by working openly and cooperatively to meet those expectations.
Board of Directors
Robert Wilson – Atikokan General Hospital
Wade Petranik – Dryden Regional Health Centre
Mark Balcaen – Lake of the Woods District Hospital
Janice Mullin – Red Lake Margaret Cochenour Memorial Hospital
Wayne Woods – Riverside Health Care Facilities, Inc.
Roger Walker – Sioux Lookout Meno-Ya-Win Health Centre
Regional Office
Kenora-Rainy River Regional Laboratory Program, Inc.
P.O. Box 3003
Dryden, ON P8N 2Z6
Phone: 807-223-8264 Fax: 807-223-7342
Chief Operating Officer: Wade Petranik
Laboratory Director: Dr. J. Kerry MacDonald
Regional Laboratory Consultant: Anna Robinson
Program Assistant: Marilyn Rustan
Organizational Chart
(See Appendix A).
Executive Summary
The landscape of Ontario’s hospital laboratories has changed dramatically. With the advent of OLA and the limited human resource pool to replace the “boomers” maintaining high-quality laboratory service requires overwhelming amounts of creativity and effort.
The primary and continuous goal of the KRR RLP is to assist Laboratories in sustaining and expanding on the high-quality service they provide. The Program’s success rests on the leadership, commitment, planning and innovation of the Board, medical, technical and support staff. As a group the Program values its collaborative successes noting hard work and
dedication are the expected norm.
The Program’s values are taken as a whole, and they guide our actions as an organization. They serve to provide a focus for how we approach our work. They collectively inspire behavior that creates a dynamic and performance-oriented organization. We believe that all of our endeavors should be directed to improving the care and the outcomes of the people
who need and use our services across the region.
This year also marks the final phase of our OLA implementation plan. It required that the laboratories measure their performance against internal and comparative benchmarks. The results identified areas for improvement that required effective corrective action plans. It is hoped that in future the data can be assessed globally in the Region to compare performance.
The Program is pleased to announce the appointment of Anna Robinson to the Council of the College of Medical Laboratory Technologists. The College provides focus and leadership to medical laboratory technology professionals to ensure they practice at the highest standards of care.
The contracted services of the Program were renewed November 1st, 2006 to February 1st, 2007 to provide defined administrative responsibilities of the Dryden Regional Health Centre Laboratory.
Detailed Description of Activities
Discipline-Specific Manuals
The Program continues to work with the Laboratories in the development of regional discipline-specific manuals. To date, Quality Management, Transfusion Medicine, Microbiology, Serology, Urinalysis, Information Technology, Hematology and Coagulation manuals have been reviewed and implemented. Draft manuals for Chemistry and Specimen await review before implementation. All manuals are generic in nature allowing each laboratory the opportunity to manipulate the documents to the culture of their facility while adhering to the researched procedures that meet specific requirements.
Equipment/Test Menus
Through a series of RFPs developed by the Program the laboratories have been successful at:
- Awarding a contract for reference Laboratory services to MDS Inc.
- Identifying a suitable blood gas analyzer (IL GEM) for purchase
- Identifying an analyzer for purchase (Adeza) for fetal fibronectin testing
- Purchasing an Osmometer (except Red Lake)
The feasibility and practicality of performing lipid profiles and thyroid studies on site versus referral to an external testing facility were examined and determined not to be cost effective. This was due to the RFP response of the Reference Laboratory that offered reduced rates for other testing should lipid profiles and thyroid studies be forwarded to them.
Education
The Program is dedicated to fostering an environment that promotes excellence and innovation in education. The lab of today is a far more complex than the lab of just ten years ago. As new discoveries advance scientific knowledge, the Technologist’s role will continue to change and expand. Even now, we can see the impact of future test considerations towards diagnosing health problems. Laboratory medicine is a critical bridge between basic discoveries and implementation of new diagnostic tests.
Details of this year’s Symposium are outlined in Appendix B.
This year the Program expanded on it’s educational commitment by producing a series of newsletters for physicians and technologists to provide authoritative information, advice and instruction on the utility of specific laboratory tests (Appendix C).
The Laboratory Director continues to provide onsite education to a variety of health care providers.
Onsite Visits
In addition to monthly teleconference meetings with the Laboratory, onsite visits have occurred in the region by the Laboratory Director and/or the Laboratory Consultant, 21 times. Appendix D.
The Laboratory Managers also meet with the Laboratory Director and Program Consultant bi- annually for 2-day sessions to deal with strategic planning, new initiatives and complex projects. These meetings provide guidance to the Laboratories in order to meet the clinical needs and established goals in each facility.
Recruitment
This year allowed the Program the opportunity to participate in the CSMLS Congress in Winnipeg as an exhibitor. Nearly five hundred people from health care, business, regulatory bodies, professional associations, education and training institutions, and government attended. The intent was to maximize the Program’s exposure and profile with potential plus introduce us to the entire national health care community. Appendix E.
The Program is pleased to announce that arrangements have been finalized with Cambrian College to provide practical experience to Medical Laboratory students in their clinical year. LOWH, as a College accredited Laboratory, will provide students with the training needed to transition them into their career path hopefully in this Region.
Bylaws
In 2006, the Board examined the Bylaws that were originally established in 1992. The intent was to determine if the Governance and administrative framework met today’s corporate environment.
With legal counsel, the Bylaws were amended and will be proposed for adoption at the next annual meeting.
EQA Challenges
QMP-LS evaluation of survey results includes an assessment of error based on the clinical significance of discordant findings. Lesser errors are assessed for results that exceed the established acceptable limits and significant errors for results that, in addition, have the potential to cause mistreatment or misdiagnosis. QMP-LS corresponds with the participating laboratories regarding the discordant findings, requesting feedback on the cause of the result and implementation of corrective action.
A Regional review of EQA challenges has revealed some unexpected changes in performance and is cause for concern. Appendix F.
This year there were 36 letters of non-conformance received. This is the highest since 1999. Although the majority of contributing causes were attributed to technical, methodology (SOPs), knowledge based, and material errors the shortage of Human Resources and its impact played a role when root cause analyses were performed.
Non-conformances
Knowledge bas – 11
SOPs (ie. not followed, missing) – 8
Materials (ie.defective reagents, mishandling QMP-LS samples) – 7
Technical (misinterpretation of results) – 5
Human Resource Shortage – 3
Clerical – 1
No Action required – 1
Corrective actions for the most part included re-education and training of staff, writing/ updating procedures, and contacting manufacturers regarding problems with materials or analytical performance.
Goals for 2006:
Goals for 2007:
- Release Chemistry and Specimen Collection Manuals. Revisit Microbiology manual to incorporate CLSI updates.
- Investigate BNP testing.
- Work with Cambrian College to expand the number of training sites in the KRRRLP for clinical student training.
- Complete RFP for POCT. Prepare and release RFPs for Laboratory Information system and Coagulation analyzer. Collate data received and make recommendations.
- Prepare laboratories for next OLA self-assessment.
Appendix A
Organizational Chart
Appendix B
KRR RLP Fall Conference
Summary:
The 2006 Fall Symposium was held in Kenora at the Best Western Lakeside Inn, on September 19, 20 and 21.
In attendance were 41 delegates, of which 37 were from our own region. Delegates included technologists and technicians as well as one Laboratory Director. The breakdown of delegates from our region include:
- Atikokan General Hospital: 1
- Dryden Regional Health Centre: 4
- Lake of the Woods District Hospital: 18 (includes Laboratory Director)
- Red Lake MC Memorial Hospital: 1
- Riverside Health Care Facilities: 7
- Sioux Lookout Meno-Ya-Win Health Centre: 6
- KRR RLP: 2
The educational format consisted of 8 guest speakers who provided presentations relating tolaboratory management and medicine.
Tuesday, September 19th
Introduction to Project Management:
Key Concepts
Workshop
Brad Niblett, BA, MBA
Director, Information Management
The Michener Institute for Applied Health Sciences
—————————————————————————
Wednesday, September 20th
Rh Prophylaxis in the New Millenium
&
Immune Thrombocytic Purpura (ITP)
Dr. Maurice Genereux, B.Sc. MD
Medical Director, Cangene Corporation
—————————————————————————
Quality Control – from Basics to Beyond
Darlene Henrickson, MLT
Director of Quality Management Gamma-Dynacare Medical Laboratories
—————————————————————————
Thursday, September 21stBuilding Relationships between
Lab & Nursing
Darlene Furlong, RN
Senior Vice-President,
Patient Services/Program Development
—————————————————————————
Risk Management
Rob VanOort, MLT, CCHRA(A)
Director, Quality, Risk and Service Development
—————————————————————————
Blasto: The View from the Lab
Lyle Wiebe, CRSP, CPHI(C), CIC, CCEP
Program Manager, Environmental Health
Northwestern Health Unit
Elizabeth Pszczolko, B.Sc., B.Ed., MLT
Head Technologist, Thunder Bay Public Health Laboratory
—————————————————————————
Tuberculosis
Dr. Greg Gamble, M.D., M.B.A.
Medical Co-Ordinator, Infection Control Network
Northwestern Ontario Regional Infection Control Network
—————————————————————————
The exhibition itself included 19 Booths with 28 vendors.
After Dinner on the Wednesday evening, everyone participated in Video Horseracing, which was provided by the Dryden Rotary Club for the evening’s entertainment.
Education
The Financial Report, as follows:
Appendix C
Newsletters / Training Tools
2006-01 Indications for Urine Culture
2006-02 Pre-Operative Testing before Elective Caesarean Section
2006-03 Anemia
2006-04 Iron Deficiency Anemia
2006-05 Erythrocyte Sedimentation Rate
2006-06 Hereditary Hemochromatosis
2006-07 Guidelines for the Use of Serum Tests to Detect Renal Dysfunction
2006-08 Guidelines for the Use of Urine Screening Tests for Drugs of Abuse
2006-09 Macrocytic Anemia
2006-10 Hemoglobinopathy Syndromes
In addition, a Quality Management Series was prepared for training technical staff:
TQM Series 1 Training and Competency
TQM Series 2 Equipment and Inventory
TQM Series 3 Process Management and Control: Pre-Analytical, Analytical & Post Analytical Processes
TQM Series 4 Documents and Records
TQM Series 5 Safety
TQM Series 6 Communication
TQM Series 7 Transportation
TQM Series 8 Referral Laboratories
TQM Series 9 Point of Care Testing
TQM Series 10 Information Technology
TQM Series 11 Quality Assurance:
- Part 1: Performance Measurement
- Part 2: Audits
- Part 3: Process Improvements
- Part 4: Occurrence Reports
Appendix D
Regional Meetings
Appendix E
CSMLS Congress Report
Introduction
The Canadian Society of Medical Laboratory Science (CSMLS) hosted its Annual Congress this year in Winnipeg.
Running from May 27th to May 31st, the Conference provided a multi-discipline scientific program covering a host of topics ranging from studies in the field of medical laboratory science to trends in health care. Concurrently a trade show was operating as a gateway to innovations in laboratory technology.
Exhibition
With the approval of the Board of Directors, the Program participated as an exhibitor to bring exposure to our region in an attempt to attract technologists as well as promote the Fall Symposium. Typically a trade exhibition is an excellent opportunity to promote awareness about a company’s products and services to medical laboratory technologists and managers who have influence in purchasing decisions for their laboratories.
There were 415 registered delegates and approximately 70 exhibitors. Of the exhibitors, three were there for recruiting purposes, including KRR RLP. The other recruiters were each representing a Health Authority in British Columbia.
We were extremely fortunate to be situated facing the end of a row occupied by a series of platinum and gold sponsors. This maximized our exposure and traffic through the display area. The colorful and dramatic backdrop further enhanced the booth appearance.
Our display was complete with job postings, pamphlets from all of the communities, contact information, Symposium outlines and a video presentation of our Region.
Exposure
In preparation for the Congress Exhibition this Office had prepared booklets about the Symposium. They were distributed to any delegate who stopped by from the provinces of Ontario, Manitoba and Saskatchewan. Program pamphlets, job postings, contact information and community promotional material were distributed to technologists inquiring about job prospects. These were predominantly students. At any one time there were three delegates from the Program and/or Managers manning the booth to interact with an estimated 250 delegates over 2 1⁄2 days.
Having attended our Symposium last year Winnipeg organizers incorporated “Exhibitor Bingo” in which delegate passports are dabbed as they visit each booth. Our “Moose on the Loose” cookbook draw was a big hit and drew a lot of curiosity. Our three winners: Tammy Moor (Swift Current, SK), Clarice Baker (Winnipeg, MB) and Janis Rudrick (Hepworth, ON) were most pleased with their prize.
Subsequent to the Trade Show, three individuals made contact with either the Program or a Manager to inquire about job opportunities. With regret, they were either not suitable or had secured employment elsewhere after the interviews were complete.
There has been some telephone interest expressed by a few Manitoba technologists to attend the Symposium however their registration forms did not arrive.
Final Comments
Those members manning our booth were pleased with the opportunity to promote opportunities in the Region. I believe our peers were left with a positive impression and trust we will hear more from them in the future.
Technologists were quick to share with us their motivation to look elsewhere for a position. One point was the difference in pay scales across Canada noting Manitoba is one of the lowest in Western Canada. Competition will increase as some areas of Alberta and British Columbia are using front-end incentive bonuses, moving expenses and a timed supplemental housing benefit to attract potential employees. The two exhibitors present at the CSMLS would not provide me with anything written to substantiate those claims so I will examine these comments though Union settlements posted on the Internet to determine our competitiveness.
Quality of life was also discussed. Today’s technologist finds being on-call an impediment therefore prefers shift work in a casual position in an urban area awaiting a full time posting.
Until this conference most technologists had never heard of KRR RLP or our Fall Symposium. This would suggest our previous circulars never made it to the right people. However, it is good to know that Kenora is well known in Manitoba as many technologists stopped by the booth to discuss their family, cottages or interest in the area.
I would recommend that the KRR RLP be present at the Manitoba Society of Laboratory Technologists Conference in future years to continue promotion and recruitment strategies.
Sincerely,
Anna Robinson
Appendix F
QMP-LS Correspondence Per Discipline
Actual Number of QMP-LS Correspondence Per Laboratory
Explanation of Discordant Results
