Pathology and Laboratory Medicine

Nov. 22, 2019 – Today I met with a group that mostly works behind the scenes, but what they do is critically important to our patients. The pathology and laboratory medicine team provides diagnostic results that affect 70 percent of all medical decisions. It’s a big responsibility, but this team demonstrates every day that they are more than up to the challenge.

Dr. Newbury shows me the electron microscope

We began the visit meeting some key members of the team, including Surgical Pathology Division Chief Dr. Robert Newbury, Lab Services Director LaVonnye Chong and Lab Supervisor Kathy Parker. These three would also serve as my guides. With my passport stamped and me suited up in a borrowed lab coat, we headed to the histology lab. This is where advanced imaging techniques, such as an electron microscope, are used to analyze cells, tissues and body fluids. Pathologists check the samples for disease, infection and abnormalities. Any biopsy or tissue that is taken out in the operating room comes to this lab for pathologists to analyze and make a diagnosis. In addition to providing these services at the Hospital, pathology processes many specimens sent to laboratories throughout the country for specialized studies. With about 13,000 surgical specimens processed every year, this is a busy place!

Speaking of busy, we then headed upstairs to the bustling main laboratory. Here, staff uses advanced technology to analyze up to 70,000 specimens every month. Several thousand more tests are sent out to various referral laboratories. There is an excellent resource on our Intranet, the Lab Test Dictionary, which has information pertaining to all of the tests performed at Rady Children’s. Information on ordering, collection, performance schedules and turnaround times are all here as well.

Learning about the impressive technology

I then stopped by chemistry, the busiest department within the lab. Using high-tech automation, they run tests on samples all day long, usually providing results in less than 30 minutes. About 500 samples are processed every day. The first of many innovative machines I saw during my visit was the hematology analyzer, which counts and identifies white blood cells, red blood cells and platelets. The test can detect abnormal cells and diagnose infection, inflammation, leukemia or an immune system disorder. There’s also a machine that prepares slides from blood samples, increasing efficiency and reducing errors and inconsistencies; and one that automatically places a slide under a microscope, allowing cells to be identified and high quality images captured. The technology is impressive! And, coming soon, a system will be implemented that allows physicians to remotely access images.

Congratulating May on her 30 years at Rady Children’s

As we navigated through the lab, I stopped to visit with May Mclean, who was busy double-checking the blood type of a sample. She’s been with Rady Children’s for 30 years and will be retiring at the end of December. I had the pleasure of presenting her with her 30-year milestone package. In all those years, she’s only spotted one blood type mismatch. But that one catch may have prevented serious problems. Congratulations and thank you for your many years of service and your vigilance! You will certainly be missed.

With all of the surgeries and transfusions (especially among neonates) that occur at Rady Children’s, the Hospital requires a steady supply of blood and platelets. We partner with the San Diego Blood Bank to make sure we have what we need. I got to see some of the technology the lab uses to irradiate and wash blood — including the “Rad Source” that looks like a giant clothes dryer — to make it as safe as possible for our patients.

Checking out the Rad Source blood irradiator

There seems to be a high-tech device for everything! As I toured another part of the lab with Microbiology Supervisor Michelle Vanderpool, we looked at a machine that monitors blood cultures and sounds an alarm when microorganisms are detected. There’s another machine that can test 12 samples at a time for respiratory viruses like flu and RSV. And yet another that performs microbial identification and antibiotic susceptibility testing. Fascinating stuff!

Taking a peek inside a machine that monitors blood cultures

We wrapped up this visit with a team photo and, back where we started, I received a gift bag filled with some great items, including an awesome laboratory team t-shirt and Rady M&M’s! As with many other departments, space is at a premium here, and I appreciate how this team is finding a way to make the most of the space they have while we develop a new master campus plan. The work they do is essential to the success of a complex health system like Rady Children’s and in maintaining the trust of our families. Thanks for the great visit!