“Most of us may not be on the front lines, but we’re not on the sidelines either,” said Anna M. Moran, MD, interim chief of Pathology & Laboratory Medicine at Penn Presbyterian Medical Center, referring to the behind-the-scenes team of 110 phlebotomists, pathologists, and laboratory professionals.
This is a big year for the Pathology & Laboratory Medicine team! The department will soon undergo a rigorous inspection led by the College of American Pathologists (CAP) in order to maintain accreditation. CAP-accredited labs maintain the highest standards and are committed to continuous improvement.
Moran leads this dynamic department alongside senior director Michael Atweh, MS, MBA, MHA, and associate director of operations, Beth Lussier, MS, MT(ASCP), as well as anatomic and clinical pathologists Bo Jian, MD, Htun Min, MD, and Xunda Luo, MD.
Located on the fifth floor of Wright-Saunders, these often-unsung heroes are responsible for conducting tests that provide essential information for detecting abnormalities, diagnosing disease, and developing treatment plans. Some interact with patients directly collecting samples, while others work behind the scenes analyzing slides, but all of their contributions are vital to patient care.
“Clinical decision-making is heavily based on pathology and lab results. It’s exciting and fulfilling to play a role in finding those answers and potentially saving lives,” Moran said. “In the ever-changing landscape of medicine, anatomic pathology and laboratory medicine services remain integral; we are part of the patient care team.”
Saving Lives in the ER, OR, and More
Undergoing a blood transfusion can be lifesaving, whether a patient experiences blood loss following a traumatic injury, produces fewer platelets while going through cancer treatment, or develops severe anemia due to an illness like sickle cell disease. As many as 17,000 blood products are transfused annually across PPMC’s inpatient and outpatient settings, including at Penn Medicine Cherry Hill. Central to this work are the meticulous medical technologists in the hospital’s Blood Bank.
Led by supervisor Roxan Reynolds, MBA, MT(ASCP), the Blood Bank is responsible for monitoring and replenishing the hospital’s inventory of blood products, such as packed red cells, plasma, and cryoprecipitate (prepared from plasma and frozen), as well as whole blood. Through a collaboration between the Blood Bank and the Trauma Center, PPMC is one of the only hospitals in the nation to administer whole blood transfusions to certain critically injured patients. Each day, the detail-oriented team ensures that all incoming blood products are properly labeled by blood type, processed, and stored. They also perform serological testing of patients’ specimens to determine their blood type and whether they have any red blood cell antibodies. This pre-transfusion testing ensures they receive compatible blood, preventing potentially lethal reactions.
“My team is very cohesive; they support each other, they communicate really well, they all are united in doing their part to ensure the best outcomes for patients,” Reynolds said. “We may not come into direct contact with patients, but we’re their cheerleaders behind the scenes. When someone has been transfused with 50+ units of blood, and we learn that patient is surviving 24 hours later and recovering a week later... nothing is more satisfying than knowing we contributed to their care.”
Collecting Samples and Calming Anxieties
No one likes getting blood drawn, but blood tests can be extremely helpful in evaluating organ function, identifying diseases, and determining whether certain medications are working. More than half of the information in a patient’s chart comes from the laboratory, and blood tests can help physicians put the medical puzzle pieces together. Luckily for squeamish patients who want answers, but fear needle sticks, PPMC's Phlebotomy team — headed by supervisor Nyesha Greer, MHA, MBA — is determined to make their experience as easy and comfortable as possible.
As frontline staff, the team’s 18 phlebotomists often serve as the faces of the Pathology & Laboratory Medicine team and the bridge between the bedside and the lab. In addition to collecting blood samples on the inpatient units, they also perform phlebotomy at several outpatient sites, such as Penn Medicine University City and the Medical Arts Building. PPMC also oversees phlebotomy services at the Mount Laurel and Cherry Hill locations in New Jersey. Each month, the compassionate, conscientious phlebotomists draw blood from an average of 6,500 inpatients, 3,500 outpatients, and 800 oncology patients, always prioritizing a warm bedside manner and accurate labeling, packaging, and storage. The Phlebotomy team also assists with pre-admissions testing and administering EKGs, and throughout the COVID-19 pandemic, team members have frequently swapped their tourniquets and color-coded tubes for testing swabs.
“No two days are the same, but our Phlebotomy team excels at adapting to change and accommodating evolving needs,” Greer said. “Personally, I really appreciate how well-rounded this field is. We connect with so many patients, work with physicians and nurses on the floor, and collaborate with researchers and our lab colleagues. We have the opportunity to work with everyone, and it’s very fulfilling.”
Rapid Testing Supports Swift Decision-Making
The lab works hard to process specimens quickly, but sometimes clinicians require rapid answers in order to make quick treatment decisions. Point of Care testing (POC) allows physicians and medical staff to achieve real-time, lab-quality diagnostic results at the patient’s bedside within minutes. If a diabetic patient’s blood sugar seems to be dipping too low, for example, the care team can’t afford to wait hours for glucose results. Similarly, if a patient shows signs of an oxygen, carbon dioxide, or pH imbalance, a blood gas test can indicate whether they may have a lung or kidney disease.
When patients require one of these tests, POC duo Amanda N. Bullwinkle, BS, MLS(ASCP), and Teresa Abbott, BS, MLS(ASCP), are there to help.
In 2020, Bullwinkle and Abbott provided the tools to perform more than 221,000 glucose tests and more than 43,000 blood gas tests. Aside from these “heavy hitters,” they are also responsible for strep tests, coagulation tests, urine drug screens, urine pregnancy tests, and many others. Inpatient and outpatient POC tests are generally performed by nurses and medical assistants, so Bullwinkle and Abbott regularly train staff to properly calibrate instruments and collect samples, troubleshooting when needed to ensure tests are accurate and reliable. They are also always looking to integrate new technology; by early summer, for example, they plan to upgrade all of their glucose monitors to provide optimal efficiency.
“Teresa and I laugh a thousand times a day, and we enjoy sharing that camaraderie with everyone we work with. The most exciting part of my job is having the chance to interact with so many people across the hospital,” Bullwinkle said. “We’re proud to represent the lab when we’re training staff out on the floor, and we always want people to come to us with questions.”