You lead a laboratory consulting firm. Tell us about what inspired you to go into laboratory work and consulting.

When I was leaving high school and trying to decide what I wanted to do with my life, I ​considered being a doctor​, but I ​​wanted to have a family and I was ​planning to​ be married. I was looking through the college courses and I saw medical technology. I love chemistry, science, and biology, and I love the mission of helping others, so this looked like a good fit for me.

Fast forward, I was working for nine years at a hospital, and I was work​ing​ three shifts. Any time of the day or night, I had no regular schedule. After nine years of working at a hospital I couldn’t take my daughter to piano lessons on Monday at 4:00pm. I worked in microbiology​,​ blood bank, hematology, coagulation​, chemistry,​ serology - you name it, I worked in it. I enjoyed the variety, but I had to work nights, weekends, and holidays. I never had a set schedule, and that really got hard. I knew that wasn’t going to change, so I had to make a change.​​

My husband found me a lab job working Monday-Friday in food microbiology, testing meat for the bacteria (O157:H7 E.Coli, Salmonella, Listeria, etc.). This was a great opportunity, in that it showed me the value of my laboratory skills and knowledge, and was transferable to any lab.  After a few years, ​​I​ returned to healthcare, ​my​​ ​original passion.  

I became Director of Lab Services at Northwest Physicians Associates. I had worked in all the departments of the hospital for the laboratory, but I really wasn’t able to be on the compliance side​.  ​W​hen I became Director of Lab Services, I had to delve into the compliance side. I loved writing procedures and policies, but this ​ ​​also included ​inspection preparedness, making sure we’re doing and documenting everything. It took me a while to get the lab organized, because it’s a process, when you have so many departments, to get that in place. We did a lot of LIS (Laboratory Information Systems) work, I had to learn IT, billing, and coding compliance. There were a lot of different things that helped me go to this next level of consulting.

And then I was at a conference in Texas. I went to a lot of COLA (Commission on Office Laboratory Accreditation) conferences because I felt like I needed to learn and later wanted to share my​ knowledge by speaking at them​. While there, I met a physician going through the courses to become a mod​erate​ complexity lab director, and she had no idea there was ​so much ​involved in a lab. We can have such great results, very precise​ and​ sensitive-specific, but you ​must​ do it exactly right.

She became my first client. She had an architect send me the drawings for her lab, and then we designed a test menu based on her patient population. I wrote her policies and procedures, did her forms, and worked with her staff. They did great. Their first inspection, no deficiencies; proficiencies [were] excellent. I was still working full-time. At that point, I had one moderate complexity lab and 13 satellite waived labs, so I was maxed out. Then I got let go. It was a really busy seven years, but I learned so much.

That's what made me go on to be a consultant.  Another physician I had worked with was starting an urgent care and asked me to help with his lab set-up. I did policies and procedures and trained his staff, and then I just kept adding from there.

You have got to have a team. You’ve really got to have a team of people that are each in their own specialized thing, bringing in information and keeping you abreast of the changes that are coming. So for me, the CDC communicating, sending out information, that is invaluable.

What does a laboratory consultant do?

Sometimes I’ll help with a lab start-up. They’re brand new, so they have no idea. Someone sold them a system and they have no idea about CLIA. I’ve had lots of inspectors say, “Hey this lab needs some help. Can you come help them clean up a little?” My mission at the end of the day is to make sure we’re putting out accurate, precise results in a timely manner for patient care. That’s what I’m passionate about. I want to make sure that those patients who are being diagnosed, treated, and monitored for diseases, that we are giving them the right information for the providers and the patients to make decisions on.

I feel that a huge part of my position is to educate and enlighten. I say things over and over again; they call them Milly-isms. “Do, document, file. Do, document, file. Do, document, file,” because if you didn’t do it, that’s the first problem. But you also ​ ​​must​ document it, because if you didn’t document it then [it’s like] you didn’t do it. And after that you have to file it so you can retrieve it when an inspector or a monitor is looking for it.

I’m going to​ be a moderator for a​ discussion at​  ASCP (American Society for Clinical Pathology) in Long Beach, CA in October, and I know staffing is going to be one of the things we'll talk about because it affects everyone. If you don’t have people to do the work, you really have nothing. And with point-of-care testing and ​ ​ molecular testing, we have so much opportunity to impact patient care. Especially at urgent cares and physician offices, we can get those results faster and better. When you have ​[testing]​ right at that patient instead of being transported thousands of miles away, it’s an improved test specimen and it’s a faster turnaround. The physician can see the patient, they can get the results, they can make ​medical​ decision​s based on that ​​information​, and they can move on and take care of that patient. I really try to maximize that kind of a workflow.

As someone who’s been in this field for as long as you have, what insights or words of wisdom can you share with other laboratory professionals who are newer to the field?

I would say keep learning and connect with peers. When laboratorians can get together, we can support each other. Most people have no idea what a laboratorian does. And there’s so much. There’s the scientific aspect of the test system, so it’s understanding the chemical and biological portions of the test and how that affects the results. There’s that technical aspect. And then you’ve got the compliance aspect. And then there’s staffing, so you’ve got HR ​compliance.​ And when you have turnover in the staff, you’re starting all over again to bring that person up to speed and to make sure that they understand. And for me, like I’ve said before, it’s repetition, repetition. You’ve got to tell people over and over. You review and you verify that they’re doing what you said. You observe and you review documentation. Always keep learning and connect with other laboratorians so we can talk about what’s happening and how we can help each other with problems.

I would love to hear about how you engage with CDC OneLab and how you use it in your work, or for your work.

I use it a ton. Whatever you communicate to me, if it’s pertinent to my labs, that’s what I’m communicating out. I forward a lot of information. We need you and you need us because we’re out in the field, but we need the resources and support from a higher level. I feel like we’re very much partners on the same team. At the end of the day, taking care of our patients, our family and friends, and our neighbors - that’s what we’re here for. That’s the point! What else is there if we don’t do that?