1. Chapter 11: Laboratory and Pharmacy Services

2. Clinical Laboratory Technologists
History of the Profession
Late 1800s, early 1900s: establishment of first clinical labs
World War I: technicians took on pathologists’ & bacteriologists’ duties
1928: Board of Registry (BOR) created by ASCP
Graduates of BOR exam known as “medical technologists”
1933: American Society for Clinical Laboratory Science (ASCLS) formed
1973: National Accrediting Agency for Clinical Laboratory Sciences (NAACLS) formed
Name changed to “clinical laboratory technologists” recently

3. Clinical Laboratory Technologists (cont’d)
Education
Bachelor’s in medical technology or a life science is standard
Associate’s degree required by CLIA for advanced lab personnel
Programs offered by universities & hospitals
Academic classes & clinical experience (3+1 or program)
Master’s & doctoral programs available
215 accredited programs

4. Clinical Laboratory Technologists (cont’d)
Course Work
Anatomy & physiology
Immunology
Microbiology
Statistics
Hematology
Chemistry
Urinalysis
Quality assurance & improvement
Safety & government regulations & standards
Communication & teamwork skills
Ethics & professionalism
Educational techniques
Research design & practice
Laboratory operations

5. Clinical Laboratory Technologists (cont’d)
Licensure, Registration, and Certification
Licensure or registration
Required by some states
Requires bachelor’s degree & passing exam
Certification
Optional, but advantageous
General & specialized
Offered by several organizations

6. Clinical Laboratory Technologists (cont’d)
General Duties
Prepare specimens, perform tests on them, & interpret results
Use complex instruments & equipment
Check for accuracy
Ensure proper function of equipment
Monitor lab process for quality control
Train subordinates in new techniques
Design & develop research experiments

7. Clinical Laboratory Technologists (cont’d)
Specialties
Clinical chemistry
Microbiology
Blood bank
Immunology
Cytotechnology
Molecular biology

8. Clinical Laboratory Technologists (cont’d)
Personal Characteristics
Responsible
Reliable
Thorough
Accurate
Good problem-solving skills
Capable of working well under pressure
Able to focus on complex tests
Communication skills
Capable of working independently

9. Clinical Laboratory Technologists (cont’d)
Employment Opportunities and Trends
>172,000 jobs
Most jobs in hospitals
14% growth from 2008 to 2018
Growth due to:
More tests required for growing population
Development of new tests

10. Clinical Laboratory Technologists (cont’d)
Professional Organization: ASCLS
Represents all lab personnel
Advocates for lab occupations
Monitors legislation
Acts as liaison to Congress & federal & state agencies
Emphasizes standards setting, continuing education, & personal & professional development
Membership benefits: online courses, workshops, conferences, national meeting, etc.

11. Clinical Laboratory Technicians
History of the Profession
Emerged in the 1960s
Developed due to:
New technologies, need for new tests
Need to free up medical technologists
Increasing popularity of 2-year community & junior colleges
1966: Allied Health Personnel Training Act—provided funding
1969: educational programs guidelines published & first exam
1973: entry-level competencies approved

12. Clinical Laboratory Technicians (cont’d)
Education
Most have either:
Associate’s degree from community or junior college
Certificate from hospital, vocational or technical school, or military
A few are trained on the job
CLIA requires associate’s degree for advanced lab personnel
196 accredited programs

13. Clinical Laboratory Technicians (cont’d)
Course Work
Laboratory methodologies
Specimen collection, processing, & analysis
Use of lab results in diagnosis & treatment
Communications
Quality assessment
Lab safety & regulations
Information processing
Ethical & professional conduct
Professional development

14. Clinical Laboratory Technicians (cont’d)
Licensure, Registration, and Certification
Licensure or registration
Required in some states
Requirements vary by state
Certification
Optional, but advantageous
Offered by several organizations

15. Clinical Laboratory Technicians (cont’d)
Work Responsibilities
Collect & prepare specimens for testing
Conduct & monitor tests
Analyze results of tests
Record findings on computer or paper
Report problems to supervisor
Care for instruments & equipment
Cross-match blood
Care for specimens
Train new employees

16. Clinical Laboratory Technicians (cont’d)
Personal Characteristics
Accuracy
Good judgment
Analytical skills
Responsibility
Precision
Eye for detail
Ability to work independently
Ability to work under time pressure
Teamwork skills
Communication skills

17. Clinical Laboratory Technicians (cont’d)
Employment Opportunities and Trends
Rapid growth: 14% between 2008 & 2018
Setting distribution:
45% in hospitals
15% in medical & diagnostic labs
14% in physician’s offices
8% in educational services

18. Clinical Laboratory Technicians (cont’d)
Professional Organization: AMT
Nationally & internationally recognized certification program
Includes clinical laboratory technicians & technologists & others
Promotes personal & professional growth & leadership skills
Benefits:
Continuing education opportunities
Annual convention
State society meetings & seminars
Professional journal
Online programs & career center

19. Laboratory Assistants
History of the Profession
Emerged in 1950s due to shortage of medical technologists
State medical associations promoted training programs
1960s & 1970s: development of educational & certification standards
1962: development of a model training program
1963: first certified laboratory assistants graduated
1967: exam made a requirement for certification
1973: ASMT approved entry-level competencies

20. Laboratory Assistants (cont’d)
Education
HS diploma or equivalent required
Many are trained on the job
Some complete formal training program
Only a few accredited programs
Programs:
Last about 18 months
Lead to a certificate
Some combine training with phlebotomist & EKG training
Include both course work & practical experience

21. Laboratory Assistants (cont’d)
Course Work
Laboratory assistant skills
Introduction to health care
Medical terminology
Laboratory administrative skills
Anatomy & physiology
Medical laboratory safety
Phlebotomy
Computer applications
Interpersonal & communication skills

22. Laboratory Assistants (cont’d)
Licensure, Registration, and Certification
Licensure or registration required in some states
Certification
Certified Medical Laboratory Assistant (CMLA) credential
Some programs prepare student for phlebotomist certification
Optional, but advantageous
No professional organization for this occupation

23. Laboratory Assistants (cont’d)
Work Responsibilities
Collect & label samples
Set up routine tests
Prepare materials for analysis
Perform low- to moderate- complexity tests
Maintain storage system for specimens
Deliver samples for testing
Recognize & report errors
Maintain equipment & supplies
Enter patient data into computer
Answer phones
Process test orders
Report results
Do billing

24. Laboratory Assistants (cont’d)
Personal Characteristics
Strong organizational skills
Eye for detail
Ability to work both independently & as part of a team
Interpersonal & communication skills
Ability to work well under time pressure
Ability to work quickly & accurately

25. Laboratory Assistants (cont’d)
Employment Opportunities and Trends
Shortage of personnel due to:
Competition for qualified staff
Lower compensation for lab work compared to other fields
Increased opportunities due to:
Aging baby boomers
Low awareness of lab occupations

26. Pharmacists History of the Profession
Colonial America: doctors, apothecaries, & wholesale druggists
Before Civil War: apothecaries trained by apprenticeship
1821: first professional association & first college of pharmacy
After Civil War
Pharmacy education shifted to state universities
Albert B. Prescott: shifted focus to academic study
State boards began licensing pharmacists
1900: pharmacy school association formed (later called AACP)
1920s: AACP adopted basic curriculum

27. Pharmacists (cont’d) Education PharmD degree required
116 accredited programs
Entrance to program requires:
At least 2 years of undergraduate work
Most programs require PCAT
Programs usually last 4 years
“0-6” programs, for high school student applicants
Residency programs following graduation increasingly required
MS & PhD degrees available

28. Pharmacists (cont’d) Course Work Pharmaceutical chemistry Pharmacology
Business management
Pharmacy practice
A clinical component

29. Pharmacists (cont’d) Licensure Required in all states
Requires PharmD & passing several exams:
All states: North American Pharmacists Licensure Exam (NAPLEX)
Most states: Multistate Pharmacy Jurisprudence Exam (MPJE)

30. Pharmacists (cont’d) Work Responsibilities
Receive prescriptions & fill them
Monitor work of technicians
Counsel patients
Confer with physicians & other health care professionals
Maintain confidential medication records
Plan, monitor, & evaluate drug treatment plans
Complete third-party insurance forms
Run a business

31. Pharmacists (cont’d) Personal Characteristics Organizational skills
Eye for detail
Conscientiousness
Reliability
Strong analytical & problem-solving skills
Good judgment & common sense
Good communication & interpersonal skills
Good teamwork skills

32. Pharmacists (cont’d) Employment Opportunities and Trends
Rapid growth: 17% between 2008 & 2018
Factors prompting growth:
Increased demand for prescription drugs due to population growth
New drugs becoming available
Setting distribution:
65% in community pharmacies
22% in hospitals

33. Pharmacists (cont’d) Professional Organization: NPhA
One of several professional associations for pharmacists
Represents interests of minority pharmacists
Works to advance standards of pharmaceutical care
Works to stimulate interest in pharmacy as a career
Benefits:
Annual convention
Regional meetings
Continuing education
Networking

34. Pharmacy Technicians History of the Profession
Began with training program by U.S. Army in mid-1940s
1940s to 1960s: establishment of a formal system of training
1975: American Society of Health-System Pharmacists (ASHP) established
1982: accreditation standards established
1983: ASHP began accrediting programs
1990s: national certification program & model curriculum developed

35. Pharmacy Technicians (cont’d)
Education
Some trained on the job
Most complete formal training
Accredited programs must:
Provide at least 600 hours of training over 15 or more weeks
Cover topics stipulated in model curriculum
Develop individualized training plan for each student
Require extensive lab experience
Offer an internship or externship in at least two settings
HS diploma or equivalent required by some states

36. Pharmacy Technicians (cont’d)
Course Work
Introduction to pharmacy
Medical terminology
Pharmacology
Pharmacy math
Commercial pharmacy practice
Hospital pharmacy practice
Pharmacy law & ethics
Computer applications
Psychology
Speech or interpersonal communications

37. Pharmacy Technicians (cont’d)
Certification
Required in some states, optional in most
Offered by several organizations
Requires passing a national exam
Recertification required every 2 years via continuing education

38. Pharmacy Technicians (cont’d)
Work Responsibilities
Accept a written prescription
Review info on prescriptions for accuracy
Prepare prescriptions
Prepare prescription labels
Choose proper containers & label them
Price & file prescriptions
Perform administrative tasks

39. Pharmacy Technicians (cont’d)
Personal Characteristics
Responsibility
Eye for detail
Organizational skills
Customer service skills
Friendly, professional attitude
Good teamwork skills
Ability to work independently

40. Pharmacy Technicians (cont’d)
Employment Opportunities and Trends
Rapid growth: 31% between 2008 & 2018
Factors prompting growth:
Increased demand for prescription drugs due to population growth
Pharmacy technicians taking on new roles
Setting distribution:
73% in retail pharmacies
18% in hospitals

41. Pharmacy Technicians (cont’d)
Professional Organizations
American Association of Pharmacy Technicians (AAPT)
Represents interests of members to public & health care organizations
Helps technicians update their skills
Provides continuing education programs, a national convention, & a career center
National Pharmacy Technician Association (NPTA)
Promotes professional development
Advocates for the profession
Conducts industry-related research