§ Wednesday, October 24, 2018 8:30 - 11:45 AM §

1 Letting Go of the Rules of Three… And How

Not to Let the MCHC Rule Your Life

─Jason Anderson, MPH, MT(ASCP), Sysmex America, Inc.

This presentation will review the history of the Rules of 3, discuss why they were intro- duced into Hematology and why they need to go away. The speaker will discuss how modern sheath flow-based hematology analyzers have made the Rules of 3 obsolete, and why the RBC Indices are much better indicators of problem samples. The audience will learn what causes abnormal and improbable indices, and what to do for resolution.

Investigating Hemolysis in the Clinical Lab

The second part will cover the physiology, mechanisms and causes of both intrinsic and extrinsic hemolysis. It will describe and compare laboratory testing/values (Hematology and Chemistry) in both types of hemolysis as well as it will help distinguish (via test re- sults) between in-vivo and in-vitro hemolysis. Numerous hemolysis-based case studies and some interesting blood facts will also be reviewed.

Sponsor: Sysmex America, Inc


Behavior-Based Safety Programs

─Christina Kulakowski, ARUP Laboratories


In Behavior-Based Safety Programs the workshop will summarize basic human behavior, including how most employees, without realizing it, have been conditioned to disregard safety rules and regulations. We will also identify the concepts of a traditional safety program and compare those with the concepts of a behavioral safety program. We will continue the discussion with how to create and maintain a positive safety culture by establishing a behavior-based safety program.

Laboratory Ergonomics

In Laboratory Ergonomics we will review proper workstation setup, as well as labora- tory ergonomic work practices and principals with a focus on repetitive tasks such as microscope use, pipetting, and miscellaneous hand tool and computer use. Addition- ally, we will identify what to include in an ergonomics program—from effective training to ergonomic assessments and everything in between. Additionally, we will discuss specific laboratory case studies and work through problem-solving exercises to identify risk factors in a laboratory setting and how to mitigate the identified risk.

Sponsor: ARUP Laboratories

3 Anticoagulation: The Laboratory’s Role Now

and In the Future

─Katherine (Katy) Whelchel, MT(ASCP)SH

Diagnostica Stago

Anticoagulation monitoring is an important part of the Coagulation department’s service to its patient population. Coumadin and heparin remain the primary medications; screening tests are still used as monitoring methods. This lecture will focus on direct heparin monitoring and the future of Direct Oral Anticoagulant (DOAC) measurement. We will examine DOACs, their effect on coagulation assays, and how best to measure them.

Sponsor: Diagnostica Stago

Clinical and Diagnostic Testing of Patients with Cardiorenal Syndrome

─Monet N. Sayegh, MD, MS, BS, MT(ASCP)SH, CLS

Siemens Healthineers

We will explain the concept of the Cardiorenal syndrome, looking at how we define it, what types there are, and what is known about the underlying pathophysiology. We will review the current guidelines for diagnostics by the ADA and by the KDOQI guidelines. Finally we will review case studies that can help us pull this information together with real-life applications of these guidelines with real-life patients.

Sponsor: Siemens Healthineers

....... Visit the Exhibits 11:45 AM - 2:15 PM ... Lots of great information! .......

§ Wednesday October 24, 2018 2:15 - 5:30 PM §

4 Pre-Analytical Concerns in Blood and Urine Testing: Best Practices and Leveraging Technology to Improve Sample Quality

─Jean Tenuta, MS, MBA, MT(ASCP)DLM, SLS, CQA(ASQ), Becton, Dickinson and Company

Studies show that 75% of erroneous results reported occur in the pre-analytic phases. This session will explore what laboratorians can do to procure samples that most accurately reflect a patient’s clinical status, while adhering to the pressures of minimizing turnaround time and improving the patient experience and outcomes.

Sponsor: Becton, Dickinson and Company

5 Unwanted Blood Clots: Venous Thromboembolism Screening and Diagnosis, and Heparin-Induced Thrombocytopenia Testing

─Paul Riley, MD, PhD, Diagnostica Stago, Inc.

D-dimer assays are most useful when demonstrated to have high clinical sensitivity to detect all patients with venous thromboembolism (VTE). This presentation will not only cover the clinical impact of VTE but it will also discuss how D-dimer, pretest probability, and utilization potentially saves healthcare dollars by preventing false positives, resulting in fewer unneeded imaging procedures. In addition, heparin-induced thrombocytopenia (HIT) is a dangerous thrombotic condition associated with heparin anticoagulant therapy. The presentation will cover HIT screening and diagnosis best practices, showing how the hospital lab can help to prevent serious complications associated with this disorder, as well as more effectively utilize monetary spending on alternative anticoagulants.

Sponsor: Diagnostica Stago, Inc.


Biologics Therapeutic Drug Monitoring

─Kelly Chun, PhD, Esoterix, Labcorp


Biologic drugs (therapeutic proteins) have revolutionized the medical care of patients with inflammatory bowel disease and rheumatoid arthritis. The specialized laboratory plays a critical role in optimizing the use of these costly therapies by providing both drug and anti-drug antibody concentrations. These assays allow physicians to person- alize dosing and make other critical medical decisions. This talk will outline key con- cepts necessary to understanding this area of specialized therapeutic drug monitoring.

Sponsor: Esoterix, Labcorp


─Donna Larson, EdD, MT(ASCP)DLM

Clackamas Community College

This session will cover a short history of worldwide biological attacks, bioterrorism agents, and the anatomy of a biological attack. Bioterrorism is not a new concept and governments have used it successfully for hundreds of years to achieve a political goal. Biological attacks are getting more sophisticated as time goes on. Release of biological agents will affect clinical laboratories and the communities in which they are located.

Sponsor: Clackamas Community College


§ Evening Session

6:00 - 7:30 PM §

Opioid Deaths - A Public Health Crisis

include the chemical nature of opioids and their families. We will also explore how



ceutical companies, hospitals, physicians, criminals and patients. The talk will


─David K Roberts, PhD, Legacy Laboratory Services

opioids cause intoxication and death. Lastly, we will touch on what labs and citizens

Opioid deaths are now the nation’s number one public health concern surpassing

can do to help address this tragedy.

automobile deaths. We will explore an array of “who done its” to include pharma-

Sponsor: Legacy Laboratory Services


§ Thursday, October 25, 2018 8:30-11:45 AM §


Molecular Testing at Point-of-Care: If It Is CLIA-Waived, Nothing Can Go Wrong. . .Right?


─Norman Moore, PhD, Abbott Rapid Diagnostics

Overuse of antibiotics is a significant global crisis. To help change prescribing habits, better diagnostics are needed at the point-of-care setting. This talk will discuss the pros and cons of newer technologies and apply them to certain disease states. CLIA-waived tests are considered by the FDA to be simple to perform with low risk for incorrect results. However, no test is infallible. Care must be taken to take the clinical samples appropriately and run the tests per package insert instructions. Additionally, no test has perfect sensitivity and specificity. This talk will go through issues that can affect results with these tests.

Sponsor: Abbott Rapid Diagnostics


Missions and Microscopes

─Heidi M. Wahlquist, MLS (ASCP) CM, MHM, Kaiser Permanente

Discussion of a medical technologist on a medical mission trip is the focus of this session. Over the past 4 years traveling to rural Guatemala for a medical mission trip, I’ve learned what a medical technologist can do in the field that is beneficial to patients, and how we can make a difference in the care provided. The session will cover the experienc-

es I’ve had, what I bring to the lab, and the value of providing a clinical laboratory on medical mission trips in rural areas.

10 Moving Hematology Forward

─Kathy Davidson Altig, BS, MT(ASCP),

Beckman Coulter, Inc

Hematology is no longer just counting cells. This session will help you understand what other information our automated hematology instruments can provide for us.

Sponsor: Beckman Coulter, Inc

Digital Cell Morphology and Advanced RBC Software with Relevant Case Studies

─Scott Dunbar, BS, MS, CellaVision

This presentation will demonstrate how artificial neural networks can standardize a very subjective area of the laboratory, the Differential Bench. This will cover WBC and RBC Morphology and Differentials with relevant esoteric case studies.

Sponsor: CellaVision


Coag for Chemists

─Kevin Foley, MT, PhD, DABCC, Kasier Permanente NW


This section re-explains clinically-relevant coagulation tests from a clinical perspective. It is meant to remove the fear-factor (pun intended) that many of us, who were trained long ago, now associate with coag testing. The session will present an overview of the differences between common coagulation tests and when they are used clinically. Several case studies will also be presented.

Natriuretic Peptides and Sacubitril/Valsartan in

the Management of Heart Failure

─Monet N. Sayegh,MD,MS,BS,MT(ASCP)SH,CLS

Siemens Healthineers

Understanding the function of natriuretic peptides (BNP and NT-proBNP), both as a cardiohormone and as a clinical test, is important in the diagnosis and management of cardiovascular disease. Clinical utility of BNP and NT-proBNP testing has had tre- mendous impact for medical professionals involved in HF and ACS patient care. This seminar presents current applications of BNP and NT-proBNP assays

Sponsor: Siemens Healthineers

§ Thursday, October 25, 2018 2:15 - 5:30 PM §

12 Molecular Multiplex Testing in Microbiology

─Kendall Bryant, PhD, D(ABMM)

Northwest Kaiser Permanente

We will discuss the current trends for molecular multiplex testing for infectious disease organisms. The advantages and pitfalls of multiplex testing will be examined, as well as the strategy to optimally utilize the multiplex testing.

Early Cancer Detection Saves Lives

─Shandee Dawn Dixon, PhD, OHSU Knight Cancer Institute

One main determinant for cancer survival is timeliness and accuracy of detection. This session will touch on some of the commonly utilized cancer detection methods in the clinical setting while discussing some of their advantages and drawbacks. The remaining presentation will then expand to introduce new genetic and molecular early detection systems being developed at OHSU Knight Cancer Early Detection Advanced Research Center (CEDAR) and around the world. Combined with their improved sensi- tivity and specificity for specific types of cancers, these technologies are also often less invasive and resource-intensive than current methods.


The Current Status of C. Difficile Testing and Influenza Testing

─Norman Moore, PhD, Abbott Rapid Diagnostics


Clostridium difficile may cause anything from asymptomatic colonization to significant diarrhea and even pseudomembranous colititis. It is quite often acquired in healthcare environments when patients are put on antibiotics that subsequently disrupt the intestinal microflora. This lecture covers the latest guidelines and data on diagnostic method- ologies. Influenza outbreaks happen yearly. The variety of strains makes predicting the severity of the season or the efficacy of the vaccine difficult. Early diagnosis can help differentiate influenza from pneumonia so appropriate therapy can be given.



Sponsor: Abbott Rapid Diagnostics


Current Concepts in HIV & Hepatitis

Circulating Hormone Biomarkers Levels in


Response to Modern Day Stressors


─Jared Jaeger, PhD, Ortho Clinical Diagnostics

─Ryan E Brown, MS, MLS, Oregon Institute of Technology

This session provides attendees with an overview of laboratory tests used to aid physicians in the diagnosis of HIV & Viral Hepatitis A/B/C. The importance of analytical sensitivity as it relates to patient seroconversion will be reviewed. We will explain the difference in available HIV assays and define and discuss various causes of Viral Hepatitis. We will also discuss the CDC Guidelines for HIV and Hepatitis screening.

Sponsor: Ortho Clinical Diagnostics

The modern human has an ever-increasing amount of stress and expectation imposed by both society and themselves. These expectations come with a cost to both our bodies and mind. Given time these stress responses can develop into pathology, loss of quality of life, and in the most extreme circumstances, the taking of one’s life. What if we can also couple these social science methods with empirical data?

Sponsor: Oregon Institute of Technology

15 How to Utilize Students Effectively in the


─Dawn Taylor, EdM, MT(ASCP), Caroline Doty, MS, MLS(ASCP), Rachelle Barrette, MLS(ASCP), SBB

Oregon Institute of Technology / OHSU

In this segment we will provide tips and hints for using students to improve productiv- ity in a busy workplace. Let student workers (unpaid labor) be a help to under-staffed workplaces instead of a burden.

How to Prevent the Brain Drain: Download and Transfer the Knowledge of Experienced Laboratory Professionals

With the current turnover rate of laboratory personnel, there is an increasing need to retain the knowledge of seasoned professionals. We will discuss methods for trans- ferring expertise to newbies and those still working in the laboratory.

Sponsor: Oregon Institute of Technology / OHSU


Thursday, October 25, 2018 Evening Session 6:00 - 7:30 PM §


A Review of Prenatal Screening Options

─Danelle Beaudoin, PhD, Legacy Laboratory Services, LLC

Prenatal screening in serum and amniotic fluid has been detecting potential birth defects and chromosomal abnormalities for greater than twenty-five years. This presen- tation will consider the clinical and analytical implications for both first and second trimester screening as it relates to Down syndrome, Trisomy 18, and open neural tube defects. Quality assurance will be briefly discussed as it relates to bringing this testing in-house. Finally, emerging molecular technologies and new screening techniques will be reviewed and compared to other non-molecular testing.

§ Friday, October 26, 2018 8:30 - 11:45 AM §

17 Surviving Instrument Downtime

─Tina J. Batsch MT (ASCP)

Newport Hospital and Health Services

If you ever have worked in a lab, chances are you have experienced instrument downtime. This session will begin with an example of a worst-case scenario result of an instrument being down. Next, back up and work round procedures will be discussed. Finally, a look at the aftermath and how instrument downtime affects the areas of billing and coding, result reporting, and the impact it had on the budget will be reviewed.

Creating a Positive Work Environment in The

Clinical Lab Workforce

Staffing turnovers, working within budget constraints, and lack of communication can lead to burnout and negativity in the workplace. This session will provide ways to overcome staffing shortages and avoid high agency placement rates by discussing re- structure in workflow. This session will also discuss working and bridging the generation gaps as more and more Millennials enter the workforce.

Sponsor: Newport Hospital and Health Services


CLIA ‘88: Thirty (30) Years Later


─Francisca Lehr, MSMT, Lehr Science, LLC

This session is about the Clinical Laboratory Improvement Amendments (CLIA) program administered by the Centers for Medicare & Medicaid Services (CMS). The objective of the CLIA is to ensure quality laboratory testing. The presenter has been inspecting clinical laboratories nationally and internationally for thirty (30) years, and will talk about the inception of CLIA to the present time. She will also discuss the national laboratory universe and top ten deficiencies in the nation including those seen in Washington and Oregon states. Other topics include: Quality Systems Regulations, Test Categoriza- tions, Quality Control (IQCP), Personnel Requirements, Certificate of Waiver (COW) study, Food and Drug Administration (FDA), Laboratory Registry, and Alaska’s Provider and Performed Microscopy Procedures (PPM) outreach. About twenty to thirty minutes are set aside allowing participants to discuss any laboratory issues they are having.

DCLS Programs: What Is It, Who Is It For, Where

Are The Programs Located, Why Would an

Organization Need This, and How Are Organizations

Utilizing These Practitioners?

─Jennifer Hayes, MLS (ASCP) CM, Oregon State Hospital

The evidence of need and the desire of many medical laboratory scientists to further their education was the driving force for the creation of the Doctorate of Clinical Labo- ratory Science (DCLS) program. The DCLS program is now picking up steam, but what exactly is a DCLS and how is it used? This session will dive into the programs offered and what DCLS graduates can expect upon completion.


Using LEAN to Achieve High Reliability in the Laboratory

─Karl E. Kamper, MT(ASCP), FACHE, Willamette Valley Medical Center


Zero Events of Harm... this statement defines the goal of every Highly Reliable healthcare organization. This seminar looks at LEAN tools and applies them to the laboratory. If you have ever wanted to understand LEAN, this hands on seminar is just for you. (Yep, we are going to break out the Legos, and have some fun.) Whether you are a beginner, or a seasoned expert, this seminar will reignite your passion for quality at the source, standard work, eliminate waste and help your laboratory achieve its goals in a culture of high reliability.

Sponsor: Willamette Valley Medical Center

20 HLA - Playing with Matches

─Shonna Sims, MBA, American Red Cross

Finding platelets for a patient who has formed antibodies to Human Leukocyte Antigens (HLA) can be a difficult task. Once HLA antibodies have been identified, selecting the appropriate platelet for transfusion, quickly, is important. This session will present an overview of the HLA system and antibody formation, as well as facilitate an understand- ing of the challenges of matching donor platelets to patients. The methodologies for HLA antibody identification will be presented, exploring difficulties encountered during testing, such as prozone effect and platelet specific antibody incompatibility.

A Cornucopia of Blood Bank Updates

─Jeanne Scott, MT(ASCP)SBB

American Red Cross, Pacific Northwest

This session will cover a myriad of blood bank topics including blood products used for massive transfusion protocols, platelet apheresis products, “jumbo” plasma and liquid plasma. We will also cover some new monoclonal antibody therapy drugs that can interfere with blood bank testing.

Sponsor: American Red Cross

Attention! Last Chance to Visit the Exhibits! Exhibits are open from 11:45 AM to 1:30 PM


§ Friday October 26, 2018 1:30 - 4:45 PM §


The HLA System in Human Health and Disease

─Paul Warner, PhD, MT(ASCP), D(ABHI), Bloodworks Northwest

The Human Leukocyte Antigen (HLA) system is the most polymorphic genetic system ever described in humans. This session will be divided into three distinct topics:

1) A description of the HLA system, including it’s pivotal role in shaping and driving adaptive immune responses.

2) How HLA testing is utilized in solid-organ transplantation.

3) How HLA testing is utilized in transfusion support (i.e. immune-refractory platelet recipients) and disease association/pharmacogenomics.

Sponsor: Bloodworks Northwest


Blood Bank Review for Non-Blood Bankers

─Terese Abreu, MA, MLS(ASCP) CM, Heritage University


This blood bank review is for those of you who have not stepped foot in a blood bank section since becoming certified. Refresh your memory and learn about new develop- ments while we walk down memory lane with ABO, Rhesus, those naughty Kidds and Lewis, just to name a few. We will review basic theory and some technical information, then try our hand at the fun stuff - solving antibody ID panels.

23 The World of Laboratory

Practice: Qualifying Edu- cationally According to CLIA or Who Can (or Can’t) Do What?

─Lisa G. Countryman MPH, CLS(CA),

MLS(ASCP), Oregon Health Authority

This session will cover the CMS regulatory guidelines qualifying individuals for specific roles in the Clinical Laboratory. These roles can be performed in all phases of Clinical Laboratory testing from Certificate of Waiver to High Complexity testing, and include individuals with various degrees: MDs, PhDs, MS, BS, RNs, and HS graduates. Clarification will be given regarding education and required experience for personnel titles including Laboratory Directors, Clinical Consultants, Technical Su- pervisors, Technical Consultants, General Supervisors and Testing Personnel.

Validation Surveys of Laborato- ries, Certificate of Accreditation and Certificate of Compliance.

─Eric V. Espinosa, BSCE. BSS(ASCP)

Oregon Health Authority

This session will cover CMS regulatory guidelines involving validation surveys for laboratories that have a Certificate of Accreditation or Certificate of Compliance. We will cover why validation surveys are performed, and answer the questions: What is a validation survey? How often is validation survey done? We will discuss the difference between the two types of validation surveys. Finally we will talk about what happens if deficient prac- tices were found during the survey process, and how to respond.

Oregon State Agency/Laboratory

Compliance Section Update

─Stephanie B. Ringsage, BS, MT(ASCP)

OHA Oregon State Public Health Lab

This session will provide a brief overview of the Oregon Health Authority and the Oregon Public Health Division with a focus on the Laboratory Compliance Section. Also discussed will be an update of the clinical laboratory testing within the state governed by the federal and state regulations. We will tell you how to contact the Laboratory Compliance Section for laboratory questions and concerns.

Sponsor: Oregon Health Authority

24 Urinalysis with Reflex to

Urine Culture - To Do or

Not to Do?

Margret Oethinger, MD, PhD (AB-

Path-MM), Providence St. Joseph Health

Many clinical laboratories offer the test called “urinalysis with reflex to urine culture”. This reflex test primarily helps our patients, because we only perform a laboratory test if it’s indicated. This means the order to perform urine culture that would otherwise needed to be added on will not be missed. There are several problems associated with this reflex test. There are no national or international guidelines available.

Syphilis Testing: Reverse


─La’Tonzia L. Adams, MD, MS

VA Portland Health Care System

In this session we will discuss the reverse and traditional algorithms of syphilis testing, including its current epide- minolgy status.

Consult Cases in Microbiology

─Margret Oethinger MD, PhD (ABPath- MM) and La’Tonzia L. Adams, MD, MS

The phone keeps ringing all day. We know them all: Questions - From rare to run-of-the-mill, cryptic to straightforward, trivial to really complicated! This session will have two parts. In part 1 two Clinical Microbiology Directors will go over all kinds of questions that are from real case examples. In part 2, we would like to encourage the audience to bring their own examples of notewor- thy questions they came across. This part should be interactive.

§ Saturday, October 27, 2018 8:30 - 11:45 AM §

25 Blood Product Updates

─YanYun Wu, MD, PhD, Bloodworks

This session will include a description of blood products and their uses. We will dis- cuss updates on new products and their application and clinical significance.

All About ABO

This session will include a discussion of ABO transfusion practice including ABO related testing and related transplantation practice.

Sponsor: Bloodworks


Practical Applications of Quality Control

─Michael Toyoshima, MT(ASCP), SC, Bio-Rad Laboratories

This lecture presents a practical overview of basic concepts in quality control. It provides an examination of some creative applications of QC in the lab. The lecture also addresses some of the more common quality control problems that laboratory professionals face on a daily basis. We will discuss reagent crossovers, and how to deal with changes in QC and/or patient values. Seminar participants will be able to describe and properly use Westgard Rules. The presentation will also focus on interpretation of QC reports, using CVR (Coefficient of Variation Ratio) and SDI (Standard Deviation Index) to pinpoint areas of increased random or systematic error. This seminar is recom- mended for any individual that deals with Quality Control in the laboratory

Sponsor: Bio-Rad Laboratories