The Doctorate in Clinical Laboratory

Science in USA

Dr. Behzad Poopak, DCLS PhD.Head Iranian Association of Clinical Laboratory Doctorsbpoopak@gmail combpoopak@gmail.com

Important Work!Important Work!

Clinical laboratory professionals are vital members of the health care team

Up to 70% of physician decisions regarding patient diagnosis and therapy g g p g pyare based on lab test results

Modern medicine could not functionModern medicine could not function without clinical laboratory professionals

www.LabScience.org

The Clinical Lab is a The Clinical Lab is a Biomedical Biomedical

EnvironmentEnvironment

R i ll t

EnvironmentEnvironment

Requires excellent technical skills as well as problem psolving, data analysis, computer

kill d d lskills, and good oral and written communication

www.LabScience.org

communication

Cli i l L b tCli i l L b tClinical Laboratory Clinical Laboratory ProfessionalsProfessionals

Highly versatile skillsHighly versatile skills

Solving medical mysteriesSolving medical mysteries

Providing vital information to save a life and cure a disease

www.LabScience.org

Who Works in a ClinicalWho Works in a Clinicalw

ww.Phlebotomist (PBT)Post HS

Who Works in a Clinical Who Works in a Clinical Laboratory?Laboratory?

LabScience.

Clinical Laboratory Technician (CLT) or Medical Laboratory Technician (MLT)

Associate (2.5 Year

( )

org

Clinical Laboratory Scientist (CLS) or

Histotechnician (HT)Laboratory Technician (MLT)(2.5 Year

Degree)

Cytotechnologist (CT)

(CLS) or Medical Technologist (MT)

Baccalaureate (4 Year

)

Directors, Managers, Coordinators

Masters, PhD, MD

Histotechnologist (HTL)Degree)

CoordinatorsMD

Problems

Need for professionals with an advanced base knowledge and clinical practice (realized with completion of the

Human Genome Project). A rapid explosion of technology an e pansion of tests & laborator ser ices and its expansion of tests & laboratory services and its Complexity. Prompted the need for consultation services for test Prompted the need for consultation services for test result interpretation, test utilization, and informatics.The emergence of numerous national studies that called for reshaping of the health care delivery system

Demands

Demands on the health care system in the U S t i ti t f t d litU.S. to improve patient safety and qualityand resource utilization.th I tit t f M di i (IOM) h i d the Institute of Medicine (IOM) emphasized patient-centered care, evidence basedpractice and information technologypractice, and information technology.

Way of Approach to Way of Approach to Problems

To Achieves These goals , restructure the training of health professionals and to training of health professionals and to provide more opportunities for inter-professional training.A b t tA subsequent report,

Health Health Professions Education: A Bridge to Professions Education: A Bridge to Quality Quality Quality Quality

These demands directly impact and highlight the clinical laboratorians’ role in diagnostics, health and treatment monitoring, and disease prevention and early g, p ydetection.

Timeline for Development of First Timeline for Development of First DCLS Program

University of Medicine and Dentistry of New Jersey UMDNJUniversity of Medicine and Dentistry of New Jersey ,UMDNJ

National Accrediting Agency for Clinical Laboratory Sciences (NAACLS)American Society for Clinical Laboratory Science (ASCLS)

DCLS as a New Member

DCLS is intended as the terminal practice d f th Cli i l L b t S i degree for the Clinical Laboratory Science profession. A t it f d d ti i An opportunity for advanced practice in multiple venues including

Cli i l i tit ti - Clinical institutions, - Reference laboratories, - Physician practices

- Public health agencies,- Government facilities,

Research organizations and - Physician practices,- Industry,

- Research organizations, and - Academic institutions,

Responsibilities of the Responsibilities of the DCLS

NAACLS categorizes the responsibilities of the DCLS into 4 areas in which these roles are utilized:

- Patient care management, - Education,- Research applications, - Health care policy development, and health care services

delivery and access.delivery and access.

To contribute to the common goals of decreasing medical errors To contribute to the common goals of decreasing medical errors, reducing health care costs, and improving patient outcomes

The Concept of the DCLS:Role, Responsibilities and

Education

DCLS will provide a critical interface between DCLS will provide a critical interface between practice, research, and health care policy. Assure the effective and appropriate Assure the effective and appropriate utilization of laboratory tests This will result in decreased costs, earlier This will result in decreased costs, earlier diagnosis, and improved patient outcomes.

Patient Care Patient Care Management

DCLS will assure - Cost effective, - Medically indicated and

Q lit l b t i - Quality laboratory services by developing/implementing critical paths/laboratory test algorithms, - participating in interdisciplinary rounds, managing and ordering

diagnostic and therapeutic studies entering notes into patient records leading - therapeutic studies, entering notes into patient records, leading laboratory utilization reviews.

Education

Effectively disseminate laboratory related i f i f iinformation as a faculty member in academe, A counselor to patients and families, A consultant to other health care professionals.Teach the public and health care professionals about over the counter and point of care about over the counter and point of care laboratory tests Educate other health care professionals about new panalytes and tests resulting

Research

In the practice of Research In the practice of Research Applications:

they will perform clinical research they will perform clinical research and outcomes studies applying research findings to clinical practice research findings to clinical practice (to include applied and translational forms).)

Health Care Policy

In practice related to Health Care Policy, DCLS participate in decision-making teams Provide consultation and input in areas such as services reimbursement professional advocacy services reimbursement, professional advocacy, ethics Human subjects oversight, expert witness testimony.j g p yintegral part of and participate in laboratory resources management……..

the first advanced practice pdoctorate in CLS offered in the

USA

Doctorate in Clinical Laboratory Science: The

ProgramProgramThe DCLS is designed for the MLS-ASCPCM with an interest in advancing theoretical and clinical learning, practice, and research. The program prepares the certified MLS for advanced practice opportunities with academic and clinical professional growth through:

Advanced expert knowledge and skills Advanced expert-knowledge and skills Critical thinking proficiency Interdisciplinary collaboration through a focused clinical residencye d sc p a y co abo a o oug a ocused c ca es de cyIncreased skills in evidence-based practice, and research methodologies C d l i l h i li i l l b iConduct translational research in clinical laboratory science

Mission Statement DCLS Mission Statement - DCLS

The mission of the DCLS is:The mission of the DCLS is:To prepare graduates for advanced practice in clinical laboratory science, instill the importance y , pof the inter-professional team approach to health care, and increase skills in evidence-based practice and research methodologies to practice and research methodologies to conduct translational research in clinical laboratory science. y

A DCLS can contribute to the inter-professional

healthcare team as:Partner with clinical pathology to serve as consultants involved in patient care and providing information to improve clinical diagnosisclinical diagnosisConsult with clinicians regarding lab test ordering and interpretationConsult with patients on understanding lab tests Develop patient centered test algorithms reflex testingDevelop patient-centered test algorithms, reflex testingParticipate in inter-professional healthcare team conferences and clinical roundsConduct outcomes studies that would benefit patients, patient safety, and Conduct outcomes studies that would benefit patients, patient safety, and the institutionPromoters of quality health care through appropriate and cost effective utilization of clinical laboratory services Advocates of patient safety by contributing to the reduction of medical errors

Program Competencies

The DCLS program implements the The DCLS program implements the competencies developed by:

1. The American Society for Clinical Laboratory 1. The American Society for Clinical Laboratory Science (ASCLS) Professional Doctorate Task Force, &

2. The Graduate Task Force of the National Accrediting Agency for Clinical Laboratory Sciences (NAACLS) (NAACLS).

All general competencies stated shall be achieved in course experiences:

Program Competencies

Patient CarePatient CareInterpersonal and Communication SkillsSkillsProfessionalismO treachOutreachContinuous Practice Improvement

Doctorate in Clinical Laboratory Science: Curriculum

Advanced Clinical Laboratory Science Core

27 creditsMolecular Diagnostics Topics in Molecular DiagnosticsTopics in Molecular DiagnosticsAdvanced HematologyAdvanced HemostasisTransfusion PracticeClinical Immunology & Transplantation Ad d T i i Cli i l Ch i tAdvanced Topics in Clinical ChemistryInfectious DiseaseOverview of Disease Processes & TreatmentOverview of Disease Processes & Treatment

Professional Core 22 creditsProfessional Core – 22 credits

Clinical Laboratory Utilization in Quality Healthcare DeliveryHealthcare Regulations & Laboratory ManagementHealthcare Regulations & Laboratory ManagementHealth Services Issues & TrendsHealth EpidemiologyHealth EpidemiologyClinical & Laboratory Diagnosis Correlation IClinical & Laboratory Diagnosis Correlation IIDCLS Seminar I DCLS Seminar IIDCLS Seminar III

Research Core 19 creditsResearch Core – 19 credits

Clinical Laboratory Data AnalysisClinical Laboratory Data AnalysisData Analysis & Interpretation IResearch Methods in the Health Research Methods in the Health Sciences Evidence-based Literature Review DCLS Project IDCLS Project II DCLS Project II DCLS Project III

Doctorate in Clinical Laboratory Science:

CurriculumCurriculum

Clinical Practice Core – 12 creditsClinical Practice Core 12 creditsDCLS Clinical Practicum I DCLS Clinical Practicum II DCLS Clinical Practicum IIIElectives – may be taken in addition to the Electives may be taken in addition to the required 80 credits:Advanced Topics in Clinical MicrobiologyRegulatory Requirements in Clinical Investigation

A Pathologist's Perspectiveg pThe Clinical Doctorate: A Boon to

PathologistsPathologistsHowever, how would these clinical laboratory specialists fit in alongside clinical pathologists? specialists fit in alongside clinical pathologists? Further, how would clinical pathologists perceive and receive these professionals? perceive and receive these professionals?

The overall understanding of the role The overall understanding of the role of the doctoral level laboratory

specialist is ke to these q estionsspecialist is key to these questions.

Will this be accepted b Will this be accepted by pathologists universally?

Probably not in the short-termProbably not in the short term.But with time and a concerted effort to work side-by side with and not against each other side by side with, and not against, each other, Pathologists and clinical laboratory specialists can improve the quality of care for patients can improve the quality of care for patients and lower the cost of healthcarelower the cost of healthcare.

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The DCLS , Our PhD Colleagues & the pathologist orking together to impro e the efficienc and working together to improve the efficiency and

quality of laboratory testing and assure patient safety.