Providence Med Center lab is going to the dogs

Medical Laboratory Observer, March, 2007 by Kateri Clemons

Once again, Providence Laboratory Services in Anchorage, AK, is supporting the Iditarod Trail Sled Dog Race by performing blood-testing services for the estimated 2,400 dogs that make up this year's 99 teams. The laboratory testing began in early February and ended this month, and the world-renowned 1,049-mile trek started March 4. The teams are traveling from Wasilla to Nome.

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Dr. Stu Nelson, the Iditarod's chief veterinarian, says, "The laboratory staff at Providence Alaska Medical Center has consistently provided us with timely and accurate blood results. This service has been immensely important to the health of these canine athletes participating in the last great race on earth, the Iditarod. For this I am extremely appreciative."

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"We are so pleased to again help protect the health and well-being of the dogs participating in the famed Iditarod," says Laboratory Director Jo Norton. "These dogs are true athletes, and testing for key health factors ensures their immediate safety in a very physically challenging and exhilarating race." One of the lab's pathologists, James Lanier, who just retired, has run the Iditarod race many times and was pictured in the 2006 Sports Illustrated Year in Sports.

New technology improves service to the vet

The testing gives the dogs a clean bill of health and, oftentimes, is the deciding factor in whether the animal is allowed to race. "We want to do our part in supporting this great event that, for many, identifies Alaska," says Norton. The Providence medical-technologist team screens for conditions such as infections, bleeding, certain bone-marrow disorders, metabolic abnormalities or starvation, liver and kidney functions, dehydration, muscle-tissue injury or damage, along with other chronic illnesses. "This year we are introducing a Web-based electronic order-entry and electronic-results computer system. The dogs will be registered with their unique chip-identification number and results can be tracked year to year," Norton says. Since the system is Web-based, Norton can deliver results to Dr. Nelson immediately.

But ease of testing was not always the case at Providence when it came to the extra work it took to test the dog teams. The laboratory services implemented lab automation in 2003 for its chemistry and immunochemistry areas. Since that implementation, additional testing such as the Iditarod has been much easier and more streamlined to handle. "We used to have extra staff on hand to perform the order entry and testing," explains Norton. "With automation, we only had to have extra staff to perform the order entry."

This year, with the new Web-based computer system, the lab did not require any additional staff. All of the registration and order entry occured at the site of the draw where the lab received orders through the Internet via a secure connection. With the advent of this newest technology and because of improved transportation to visit the dogs, the dog teams in Kotzebue were able to stay there this year for their draws instead of flying out.

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The other race

"When I began my position in 2002 as laboratory director," says Norton, "I could see the staff was working hard--extremely hard--but they focused on many tedious manual tasks and not on the difficult testing or abnormal patients. I could see the potential for more automation and how updated equipment would benefit staff." With her leadership team, Norton put together a strategic plan, which included revamping all lab instrumentation, purchasing a new computer system, redesigning work processes, and creating a new culture.

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"We tied our strategic plan to our organization's four operating principles--quality, customer satisfaction, people, and financial performance--and set targets for each area. The overall vision was to create efficiencies, which would allow us to increase our capacity and expand our testing into the outreach market." With their market assessment and a financial pro-forma conducted, the team presented the strategic plan to the executive team. "It was well received and approved. We were also given a designated capital fund for three years in order to implement the strategic initiatives." The race was on for Norton and her colleagues. "I am happy to say we have achieved great strides in all of the four principles and implemented all the initiatives within that time frame."

Norton has high praise for "the talented staff we have in the lab. They have provided a lot of insight in how to make this a better place to work." Originally, the leadership team set out with these projects without staff input. "Between 2003 and 2004, we started seeing morale take a nose dive. It was an eye-opener to our team to step back and allow staff to provide more input. They needed to know they had value, and we needed their voices and suggestions. We began to build trust, which is the foundation of a healthy culture." On the lab's most recent employee-satisfaction survey, one consistently tracked question--"I recommend my department as a great place to work."--was 4.42 on a scale of one to five, "the highest we have ever seen" says Norton.