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What I Do

What I Do. Donald Giacherio , Ph.D. Clinical Associate Professor of Pathology Director, Chemistry Section Laboratories Director, Specimen Processing Director, Ancillary Site Testing Services .

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What I Do

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  1. What I Do Donald Giacherio, Ph.D. Clinical Associate Professor of Pathology Director, Chemistry Section Laboratories Director, Specimen Processing Director, Ancillary Site Testing Services

  2. Direct the Operations of the Chemistry Section Laboratories • Automated Chemistry • Special Chemistry • Drug Analysis and Toxicology • Immunology • Point of Care Testing

  3. Key Personnel • Sue Stern -- Administrative Manager • Eric vasBinder -- Automation Supervisor • Mara Williams -- Special Chemistry Supervisor • Sheridan Mattson -- Toxicology Supervisor • Linda Thomas -- Immunology Supervisor • Melanie Herbert -- Evening and Midnight shift • Denise Twarkowski -- Point of Care

  4. Chemistry Laboratory Financials

  5. Limited budget growth despite significant new test growth • CVC OR Lab • Quantiferon TB testing started • Cotinine • Hemoglobinopathy Evaluation • Troponin I testing in Emergency Department • Continued growth of transplant program support • Psychiatry Addiction Treatment Program support • Ethyl glucuronide, GC-MS drug screens, Oxycodone, Buprenorphrine, Methadone • Virus serology testing moved from Microbiology • EBV, HSV, CMV, Toxo, VZV, Mumps, Measles, H. pylori

  6. Chemistry Laboratory Services Chemical Laboratory automation line volume 3500 tubes/day 8 million tests/year 24 x 7 service

  7. Our labcell configuration 3 - Advia 2400’s 3 - Advia Centaur’s 2 - Sample managers 2 - Centrifuge XL’s 2 - Decapper modules

  8. “Lean” in Chemistry • Redesign of sample handling area of the lab • Monitoring of STAT sample turnaround times • Visual cues system • Mail in immunosuppressant samples • TAT for inpatient immunosuppressant drugs • Selected as one of 11 health system wide areas for new “Lean Implementation Teams” training of all techs

  9. POCT at University Hospitals Whole Blood Glucose: 280 meters, perform 600,000 patient, tests per year Coag tests: 8 meters in OR’s of Main, Mott, and CVC for PT, aPTT, ACT Blood Gas / electrolyte analyzers in OR’s and ED Creatinine on i-STAT for three Interventional Radiology sites

  10. Intra-operative PTH: Analyzer moved to OR for parathyroidectomies: 300 cases last year. Measure PTH at baseline, 10 min, and 15 min post excision.

  11. Ancillary Site Laboratories: Key Personnel • Mary Lou Erber -- Administrative manager • Theo Jones • Denise Brown • Suzanne Clark • Cindy Stutzman • Annette Collino

  12. POCT at Health Care Centers Hemoglobin A1C: 26 DCA Vantage analyzers at 14 sites, perform 30,000 tests per year Lipid profile: Cholestech LDX at Domino Farms, CVC Blood draw station Blood gas / Electrolytes: i-STAT at Kellogg Eye Center, EAA Surgery Center, Livonia Surgery Center, Canton Infusion Center

  13. Specimen Processing • 9000 samples per weekday distributed to labs • Sendout testing • Key Personnel • Harry Neusius • Bonnie Grayson • Beth Lawless • Renee Stoklosa • Mary Deis • Michael Horgrow • Lakesha Holloway

  14. Research • 7.5 % effort on NIDDK funded Michigan Diabetes Research and Training Center • Martin Myers, Ph.D. and William Herman, M.D. • Direct Chemistry Core Lab on 6th floor BrehmBldg • Lab provides service for over 45 diabetes related projects, performing 18,000 tests / year • Assays for Lipids, Hgb A1c, Glucose, Insulin, C-peptide, Leptin, Adiponectin, Ghrelin, PAI-1, Luminex cytokine profiles

  15. Research • Development of POC assay for Apo B and Apo A1 • With Alan Hunt, Ph.D. and Robert Brook, M.D. • Apo B is major protein of LDL, Apo A1 is the major protein of HDL • Work on microfluidic cartridge device using fluorescence polarization immunoassay. • $30,000 MICHR award, $95,000 seed money from a venture capital company, Net Scientific

  16. Teaching • Coordinate rotation of Pathology Residents through the Chemistry Lab • Review Hemoglobinopathy evaluations • Review 2nd trimester maternal serum prenatal screen results (Quad Test) • Meet daily with residents to review lab issues

  17. So Kurt, who do you think the Lions should draft this week? Anthony Costanzo, OT, Boston College Prince Amukamara, CB, Nebraska

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