VERNON MEMORIAL HEALTHCARE
Have you ever wondered what happens to the blood sample that you give when your medical provider orders lab tests? How do doctors diagnose disease and determine if treatment is effective? How do practitioners choose the right medication for treating infection?

Welcome to the medical laboratory at Vernon Memorial Healthcare. Working much like the circulatory system, the lab is a main artery of VMH - responsible for carrying blood throughout the hospital and clinics 24 hours a day. The lab reaches every area of the hospital - every patient room, department, clinic and nursing unit with quiet efficiency. From strep throat to leukemia, many diagnoses largely are based on lab results.

Ensuring every test is done exactly right every time is the work of laboratory staff who include a highly skilled team of technologists, technicians and phlebotomists. This team works together to determine the presence, extent or absence of disease and provide the valuable data needed to evaluate the effectiveness of treatment. According to VMH Laboratory Manager, Gary Tricker, “Laboratory staff may spend less time with the patient and have a less visible role than nurses or doctors, but they are just as dedicated to the health of our patients”. The VMH Laboratory is staffed 24 hours a day, 7 days a week to perform testing for all of the VMH affiliated medical clinics as well as independent providers and local veterinary offices. Over 180 procedures can be performed in the VMH laboratory. Last year the VMH lab performed 71,381 lab tests on 16,615 patients.

Specialty Sections

The Chemistry section of the lab is the most highly automated. Here, tests are run for diabetes, metabolic disorders, thyroid, kidney, liver and heart disease. Medication levels are also routinely performed. For most tests the blood sample is spun in a centrifuge to separate the blood cells from the serum or plasma, which is used to run the tests. Testing includes glucose, electrolytes, cholesterols and various enzymes.

Microbiology includes the study of both bacteria and viruses. Many tests in microbiology have been traditionally manual procedures. While some tests such as a rapid Strep or influenza screen can be done in 15-20 minutes, some cultures may take several days or even weeks depending on how fast the organisms grow. Some microbes grow well in the body, but not as well on culture media in the lab. In an effort to speed up this process the lab has purchased an automated blood culture system that reads the bottles every ten minutes. This decreases the time of detection for positive cultures. When a bacterial infection is found lab techs are usually able to perform sensitivity testing to tell the physician which drugs will work best to eliminate the infection.

Blood Bank specialists in the VMH lab determine the type of blood to be given to patients, making sure it is the correct type and is free from disease. VMH also offers a special program where qualified patients donate their own blood ahead of time for planned surgical procedures. This is called autologous donation.
The newest piece of equipment used in the blood bank is an automated cell washer. This $6,100.00 piece of equipment was recently purchased for the laboratory by “Friends of VMH”, formerly the VMH Auxiliary. The cell washer automatically performs the steps that remove interfering proteins from the blood cells in the crossmatch and antibody screening procedure which must be done before a patient can receive a blood transfusion. “These instruments can be costly,” Tricker said, “but are extremely important in helping report timely, accurate results.” The cell washer will reduce hands on time for patient testing and allow the laboratory to learn test results faster so that VMH medical providers can get a head start on the appropriate treatment of the patient.

VMH is currently associated with The Blood Center of Southeastern Wisconsin. The Blood Center supplies the majority of our blood product needs. VMH and the Blood Center host blood drives in the VMH community rooms four times a year. Blood drives in 2005 are set for Tuesday, March 29th from 9:00 am to 2:00 pm... Thursday, June 30th from 11:00 am to 4:00 pm... Wednesday, September 7th from 9:00 am to 2:00 pm... and Wednesday, December 28th from 11:00 am to 4:00 pm.

The Hematology section of the lab is responsible for conducting tests on whole blood and other body fluids. This section is also highly automated. The tests performed include hemoglobin, white blood cell counts, red blood cell counts, and white cell differentials, which tell the medical provider what types of white cells are present in the patient’s blood. These tests aid medical providers in diagnosing diseases such as leukemia, sickle cell disease, various infections and anemia’s.

Urinalysis can reveal diseases that have gone unnoticed because they do not produce striking signs or symptoms. Examples include diabetes and chronic urinary tract infections. The most cost-effective device used to screen urine is a paper or plastic dipstick. This microchemistry system has been available for many years and allows analysis within one minute. The color change occurring on each segment of the strip is read by an instrument which sends results to the computer. Immunology in the lab is the study of our protection from foreign macromolecules or invading organisms and our responses to them. These invaders include viruses, bacteria, protozoa or even larger parasites. Immunology testing at VMH includes the tests for Lyme disease, Giardia, Cryptosporidium and other diseases.

Coagulation is the process of forming a blood clot. Most people think of blood in its liquid state, but its ability to thicken into a blood clot is a vital part of the body’s natural defense. Over twenty different protein factors are required for a blood clot to form at a site of injury. Further chemical interactions are required to dissolve the blood clot as the body heals. Certain blood coagulation disorders increase the risk of developing blood clots in the blood vessels. When a clot forms in blood vessels, it stops the flow of blood. If this occurs in a vital organ such as the heart, lungs or brain, the clot can be fatal. The test D-Dimer is utilized to help detect these clots. The tests Protime and PTT are most often used to monitor the blood thinners used in treating blood clots, after heart attacks, and often after joint surgery.

The laboratory at Vernon Memorial is also a teaching facility. Students from Western Wisconsin Technical College in LaCrosse complete a rotation through all laboratory departments as part of their small hospital training. Students learn how to manage the demands placed on them to provide reliable results from the many different speciality sections at the same time.

Quality is Critical
Laboratory staff need to be meticulous in following procedure to ensure quality in their testing methods and results. All the labs’ work is based on making sure specimens are identified properly and results are reported accurately. Tricker said the lab runs on a system of checks and balances. For example, staff follow procedures that detail step by step how a test should be done, to make sure it is done the same way no matter who is doing it. This includes how they check the instruments, run the tests and report the results. In addition to following endless procedures, lab staff participate in internal quality improvement initiatives to become more efficient and even more accurate. They also take part in a national proficiency testing program to see how they compare to other similar labs throughout the country. “Many of the lab staff have worked here a long time and all are very proud of what they do,” Tricker said. Although often hidden, laboratory staff - like the circulatory system - perform a vital task with steadfast skill.