Medical Laboratory Professionals Week 2018

by Pastor C T DennieRetired Medical TechnologistOver the past 30 years, this country has witnessed an increase in medical laboratories and professionals, all dedicated to providing the public with relevant clinical and public health services. The mixture of public and private enterprises has expanded both the range and availability of medical laboratory services to the nation, thus enhancing the health product.I have been privileged to personally observe the evolution of these services from the rudimentary state of thirty seven years ago, to the technologically sophisticated operations of today.Understanding the role and contribution of the Milton Cato Memorial Hospital Pathology Laboratory (MCMH Pathology Laboratory) over the years, both in terms of human resource and technical developments, may provide the context for appreciating the state of Medical Laboratory operations today.In the area of human resource, the fact is that medical laboratory workers (laboratorians) of today stand on the shoulders of the achievements of the pioneers of the past who, during their tenure at the Kingstown General Hospital (KGH)/MCMH Laboratory, laid the foundation for much of what is happening today. Mention must therefore be made of:

• Mr Owen Jackson under whose leadership and foresight as Chief Laboratory Technologist (CLT), the country’s only medical laboratory at the time, was truly brought into the modern era. Mr Jackson, an innovator and achiever in his own right further went on to be a pioneer in private laboratory operations in SVG with the founding of CRL. He continues to make his contribution today.l Mrs Claudette Williams who through sheer determination advanced the services in the Microbiology Department, and, subsequently dedicated herself to Quality Systems implementation as CLT. In her chosen field, Mrs Williams did yeoman service in a visionary manner.
• Mr Cosmore Dennie, who managed the expansion of the range of services in the Clinical Chemistry Department, thus providing huge cost savings to Vincentians through the introduction of testing in the areas of Tumour Markers (e.g. PSA), Reproductive Endocrinology, Therapeutic Drug Monitoring and Drugs of Abuse among others. As Senior Laboratory Technologist, Mr Dennie also made his contribution to laboratory and hospital safety.
• Ms Angella Bacchus, who for many years provided skilled and experienced service as the head of the Haematology Department, and who continues to make her contribution in private service
• Mr John Bascombe who headed the cytology department and who subsequently went on to be the founding manager of Sigma Laboratories.

These individuals made and in some cases are still making their contributions to national development in a generally unheralded manner in this most critical field of health.In the area of technical operations, it is said that 80 percent of medical decision making is based upon laboratory results. Since this year’s Laboratory Week (April 22-27) brought both workers and laboratories into focus under the theme: ‘Medical Laboratory Professionals get results’, then it is useful for me to share with the public aspects of the operating environment that are necessary in such a vital service.This brings us therefore to the concept of Quality Assurance, which essentially is the operating environment that is envisioned by the rules of ISO 15189, the international accreditation standard for medical laboratories. It is not my intention to go into the details of this standard but simply to let the public know that Laboratories have a reference point to which their operations are guided.A Quality Assurance Programme covers three general phases of the testing process; namely, Pre-Analytical; Analytical and Post Analytical.

Pre-Analytical phaseThis phase of testing should be managed by documented procedures (including a Lab User’s Manual) that cover test requisition, patient preparation, sample collection, sample storage and transport to the laboratory.It is in this phase that the public plays a critical role in determining the outcome of laboratory testing. For example, for 24 Hour Urine Protein tests, if all the urine is not collected and stored as instructed, the laboratory will return a result that has been compromised by the patient/user of the service.Analytical PhaseIn this phase, the laboratory maintains standard operating procedures for sample preparation, sample testing, equipment maintenance, reagent use, and quality control in order to guarantee the accuracy and reliability of testing. The ability to pay attention to details and also to troubleshoot is essential for the laboratorian.

Post AnalyticalThis phase involves the review/interpretation of results, collation of results and the issuance of reports. The training, professionalism and experience of the laboratorian is very important here because patient outcomes may be drastically affected. For example, a neonatal glucose of 25 mmol/l may suggest compromised sample integrity, whereas, fasting blood sugar of above 25 mmol/L for a non-institutionalized person, will require immediate verification and reporting.

Certainly, Medical Laboratory Science is exactly what the name suggests, Science, therefore, the public should expect and be assured of, the application of verifiable, scientific approaches in the management of laboratory operations throughout SVG. Yes, Laboratory Professionals do get results, the question is, what is the result? Is it merely the generation of an accurate report or more significantly, the impacting of user’s health? If it is the latter, and I believe that it is, then Laboratory Professionals of today will not only be focused on generating reports, but on positively affecting patient’s outcomes. This requires the application of a compassionate heart and the use of the scientific mind as we advance this field of medical laboratory science to the benefit of the nation.