Live from Kyrgyzstan

Greetings from Bishkek, Kyrgyzstan! And Happy St. Patrick’s Day to those of you with Irish heritage and those who just think they’re a bit’o’Irish on this day! I have been in Bishkek, Kyrgyzstan the past week, joining colleagues to work with the Kyrgyzstan laboratories on preanalytical processes and phlebotomy techniques that are so important in patient safety and specimen integrity. Over the two weeks we are here, we are working with more than sixty people and have a very full agenda. I’m scrambling to refresh my Russian/Kyrgyz greetings and phrases, but oddly enough it’s coming back. I doubt I’ll ever master the Cyrillic alphabet, but the accents are growing more familiar.

We began last week with full-on challenges: agenda changes, delayed supplies and the ‘usual’ need to be flexible and unflappable. Our shipped supplies and materials were delayed in customs for two days, so we were “working without a net.” Our team works well together and we have been well received by our Kyrgyz colleagues so that diminishes difficulties. They are a lively and vocal group, giving us lots of opportunity for dialogue which is always a pleasure. We are finding that their knowledge is strong but their experience and skills with the standard equipment used to collect blood is lacking. Some of them have never seen or used devices we take for granted—evacuated disposable tubes and safe, sterile needles are often not available in rural parts of the country—and some of the statistics shared with us by their national infection control director are staggering. Some of the examples shared: uncapped, reused glass tubes for transport of serum to reference lab testing sites; rubber-stoppered pipettes reused after rinsing in water or alcohol; requisitions rolled up and used as “tube stuffers” that served as caps to specimen bottles; confusion on the difference between serum and plasma; single digit numbers written in wax pencil as the second (an in some cases, first) patient identifier. All are challenges they are facing in rural collection sites for lack of resources and training. Fortunately the groups we are working with are in position to change that, and it is energizing to see how much they really want safety and progress for their healthcare workers and patients. As always, I learn much more than I teach…and this week has been no exception. In between training weeks, we spent Saturday with a high level group facilitating and mentoring a country-wide process improvement project, and helping to identify and outline next steps. Working side by side with our CDC partners was an opportunity to learn and hopefully to contribute to the discussions and strategies ahead. This is where change will happen, and it’s exciting to see it up close and personal.

Next time I hope to share some customer service experiences with you, as we gather stories and experiences from our Kyrgyzstani colleagues about how they address and resolve issues at the point of service to patients. If you’d like me to ask our colleagues any questions while I’m here, email me at bsumwalt@pacbell.net . It’s a different world, but in so many ways it’s the same issues we face in our laboratories back home.

 

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Beverly Sumwalt, MA, DLM, CLS, MT(ASCP) is an ASCP Global Outreach Volunteer Consultant.

Service Snippets

I’ve gotten some great responses regarding my recent blogs on Customer Service, and want to share some of these with you. Good ideas always generate more good ideas, and I think you will find these fun ideas very interesting. As we know, patients can usually only judge our quality and testing performance by what they see and what they experience at the drawing station…so, with permission to share, here are two excellent ones:

Children are often the most difficult to draw, and take more time and technique than adults. One laboratory draw station, part of a large metropolitan children’s hospital, has a system that works to help keep children occupied and parent’s angst levels lower during the busiest times. When patients show up for a phlebotomy and the wait is greater than 15 minutes, they are given a “restaurant beeper” and a coupon for the coffee/juice cart outside on the patio, and then are paged when the phlebotomist is ready for them.

A 25 bed rural hospital in West Virginia surprises a lot of people when they go out to the parking lot, and do a “vehicle draw” for patients that have difficulty making it into the hospital, for older patients who struggle with wheelchairs etc., or if someone is just too ill to come into the building. The staff is truly committed to serving their patients and proud that something so small can make such a difference. 

Perhaps these two fine examples (as well as the one from our colleagues in Africa) will generate some ideas about how your operations might make little changes that accommodate patients, and provide the best service you can offer—which we know directly translates to showing patients the quality we are proud of as laboratory professionals. Explore it with your teams, get some ideas going, and make it work for you.

I will be leaving soon for another global experience with colleagues from another part of our world and we will be working on the pre-analytical processes (including the importance of customer service) for our external AND internal customers. I’ll be writing my next blog “live from Kyrgyzstan!”

In the meantime, I’d be interested to know what you’d like me to ask our colleagues while I’m there. You can email me at bsumwalt@pacbell.net  and perhaps we’ll get a little international dialogue on the topic…and as always, I look forward to hearing your comments and ideas for building better laboratories and processes around the world, and at home in our own communities!

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Beverly Sumwalt, MA, DLM, CLS, MT(ASCP) is an ASCP Global Outreach Volunteer Consultant.